Genital self-perception is psychological dynamite, in that a poor self-image can have devastating repercussions in the sexual arena. And this personal anatomical scorecard doesn’t just affect women. Almost all men worry about the “short penis syndrome,” in which the man becomes preoccupied that his phallus is too small. This begs the question: too small for what? For intercourse? For masturbation? No, young men worry that their penis is smaller than that of their peers, and that this shortfall implies that they’re less of a man.
What Does “Normal” Mean?
Many women suffer from similar perceptions about their vaginas. This is largely an internet phenomenon, where there are numerous images, photos, and videos (often from porn) about what a “normal” vagina should look like. Occasionally, their perceptions come from inconsiderate partners who make negative comments about the woman’s vaginal appearance. Unlike with men, however, there is no consensus among gynecologists, and no universally accepted measurements, that describe the average vagina—because there is no average. The visible parts of a woman’s external anatomy—the perineum (the area between the vagina and the rectum), the clitoris, and the labia majora and minora—come in numerous configurations and colors. Probably the most common complaint is that the labia minora, the smaller, inner vaginal lips, are too large. While not a medical problem, this condition can be annoying. Large labia can protrude from undergarments and interfere with tampon insertion. Needless to say, this anatomic variant is not a problem at all for men.
I’ve been told by more than one patient that a woman’s vagina is supposed to resemble the petals of a rosebud. I’m not sure of the source of this imagery, but having examined vulvas for over four decades, I’ve never seen one that looks like a rosebud, or, for that matter, any other flower.
Pinpointing The Source Of Concern
If a patient expresses concern about the appearance of her genitalia, the standard advice from my specialty is to sound out the patient to explore the reasons for her concern. Has something changed, or was there an inciting factor? Is her perception interfering with her sex life? Gynecologists are encouraged to reassure such patients that her vagina is normal and in no way a medical problem. Going through a cosmetic procedure, they maintain, is not going to have any medical benefit.
The Importance Of A Skilled Surgeon
While that may be true, I disagree with the anti-surgical bias. Similar comments about “no medical benefit” can be made about nose jobs or cosmetic breast surgery, but that ignores the profound psychological benefit that such surgery can have for selected patients. If a patient wants to discuss the pros and cons of vaginal surgery and/or labiaplasty, I don’t hesitate to recommend consultation with a competent vaginal surgeon. Both gynecologists and plastic surgeons do these procedures, but the key here is experience, training, and competence. My preference would be a skilled cosmetic surgeon—experience with vaginal surgical techniques is crucial.
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