Shrinking Labia: Why the Labia Get Smaller and What Helps

The labia change throughout life, and many women are surprised to find in their forties, fifties or later that their inner labia have become smaller, flatter or harder to see. Searches for labia shrinking, disappearing labia and “where did my labia minora go?” are common, and the answer is reassuring for most women: some shrinking with age is a normal effect of hormonal change. Occasionally, though, shrinking labia are a sign of a skin condition that should be treated. This guide explains the difference.

We cover why the labia shrink, why it can happen on one side, whether small labia are normal, which treatments help and when to see a doctor. If the change you have noticed is mainly in the outer lips, which look flat, wrinkled or saggy, our guide to deflated labia majora is the better place to start. To see how much labia vary in healthy women, read our guide to labia shapes. And if you arrived here looking for ways to make large labia smaller, the section on how to shrink labia below explains why labiaplasty is the only reliable option.

Can Labia Shrink?

Yes. The labia minora, the thin inner folds of the vulva, depend on oestrogen to stay full and elastic. When oestrogen levels fall, they tend to become thinner, shorter and paler, and they may blend into the surrounding skin so that the line between the inner and outer labia is less obvious. The labia majora, the outer lips, also lose some of their fat pad with age.

Measurement studies show the effect. A review of ten population studies found that the inner labia were wider in premenopausal women than in postmenopausal women^[2], and in a Swiss study of 657 women aged 15 to 84, the length of the inner labia decreased steadily with age^[3]. So if your inner labia are smaller than they used to be, you are far from alone.

At what age do the labia minora shrink?

Most women notice a change around or after the menopause, typically from their late forties onwards, and the change continues gradually over the following years. Shrinking in your twenties or thirties is less common. In younger women it is most often linked to breastfeeding or another low-oestrogen state, or to lichen sclerosus, which can occur at any age. Any noticeable change at a young age is worth discussing with your GP.

Why Is My Labia Shrinking? Common Causes

Menopause and genitourinary syndrome of menopause

Falling oestrogen around the menopause thins the skin and lining of the vulva and vagina, reduces natural moisture and makes the tissues less elastic. An international consensus panel named this collection of changes the genitourinary syndrome of menopause (GSM) in a 2014 consensus statement ↗, and specifically included changes to the labia majora and minora, alongside dryness, burning, irritation, discomfort during sex and urinary symptoms such as urgency and recurrent infections^[1]. Shrinking labia minora are part of this picture. Our guide to treatment options for vaginal atrophy covers the internal symptoms in more detail.

Lichen sclerosus

Lichen sclerosus is a long-term inflammatory skin condition that most often affects the vulva. It usually causes itching, which can be intense, along with white, shiny or crinkled patches of skin, easy bruising or splitting, and pain during sex. Over time, untreated lichen sclerosus can cause scarring that changes the architecture of the vulva: the inner labia can shrink, flatten or be absorbed into the surrounding skin, the clitoral hood can fuse over the clitoris, a form of clitoral adhesions, and the vaginal opening can narrow. It can affect women of any age but is most common after the menopause. The NHS guidance on lichen sclerosus ↗ describes the symptoms.

Lichen sclerosus should be diagnosed and treated by a doctor. UK guidelines from the British Association of Dermatologists recommend a very potent steroid ointment as first-line treatment, with long-term follow-up^[4]. The evidence that treatment matters is strong: in a 2015 prospective cohort study of 507 women in JAMA Dermatology ↗, adhesions and scarring developed in 3.4% of women who used their treatment as advised compared with 40% of those who did not, and no compliant patient developed vulval cancer, compared with 4.7% of partially compliant patients^[5].

After childbirth and while breastfeeding

Oestrogen levels drop after birth and stay low while breastfeeding, so the vulva and vagina can look thinner and feel drier for a while. In a study of 117 women at their postpartum check, signs of vaginal atrophy were far more common in breastfeeding women than in those who were not breastfeeding^[6]. These changes usually improve once periods return and breastfeeding stops. A tear during birth, or its repair, can also change the shape of one inner labium permanently.

Weight loss

Significant weight loss mainly affects the outer labia, which contain fat, leaving them flatter and looser. This can make the vulva look smaller overall. Our guide to deflated labia explains the options for lost volume in the outer lips.

Other causes

Treatments that lower oestrogen, such as some breast cancer therapies, can cause the same changes as the menopause. Other inflammatory skin conditions affecting the vulva, such as lichen planus, can also cause scarring. A doctor can usually tell these apart by examination, sometimes with a small skin biopsy.

Labia Minora Shrinking on One Side

Many women first notice shrinking on one side, or realise that one inner labium is now noticeably smaller than the other. There are several possible explanations. The two sides are often different to begin with, and as both shrink, the difference can become more obvious. A tear or stitches after childbirth can change one side. Lichen sclerosus does not always affect both sides equally. If one side has changed over weeks or months, particularly with itching, soreness or skin changes, ask your GP to examine you. If the difference has been there for years and causes no symptoms, it is usually a normal variation; see our guide to uneven labia.

Small Labia and No Labia Minora: Is It Normal?

Some women have very small inner labia, or inner labia that are hidden completely by the outer labia, and wonder whether they are missing something. They are not. Measurement studies have recorded inner labia widths from as little as 1 mm in healthy women^[2], and small or barely visible labia minora are a normal variation. The medical term for unusually small labia is labial hypoplasia, but it simply describes size and is not, on its own, a problem.

What matters is change rather than size. If you have always had small inner labia, there is nothing to treat. If labia that used to be visible have become smaller, especially after the menopause or alongside itching or soreness, a check is worthwhile. Searches for a “vagina with no lips” or “no labia” usually describe one of these situations: naturally small inner labia, inner labia that have shrunk with age, or outer labia that have become flat. Our article on innie vs outie vaginas explains why many women’s inner labia are hidden.

Can Labia Shrinkage Be Reversed? Treatment Options

Treatment depends on the cause, and it is worth being clear about what each option can and cannot do.

Vaginal oestrogen and moisturisers

For shrinking linked to the menopause or breastfeeding, low-dose vaginal oestrogen (as a cream, gel, pessary or ring) thickens and moisturises thinned tissue. A Cochrane review of 30 randomised trials including 6,235 women found that vaginal oestrogen preparations improved the symptoms of vaginal atrophy compared with placebo, with no clear difference between the different types^[7]. Vaginal oestrogen can make the labia look and feel healthier and less fragile, though it will not restore labia to their size at 25. Non-hormonal vulval moisturisers and lubricants help with dryness. Your GP can advise whether vaginal oestrogen is suitable for you; the NHS page on vaginal dryness ↗ has more information.

Treatment for lichen sclerosus

Steroid ointment controls itching and inflammation and, used as directed over the long term, helps prevent further scarring and shrinking^[4][5]. It does not usually bring back tissue that has already been absorbed. Where scarring has narrowed the vaginal opening or covered the clitoris, specialist surgery is sometimes needed once the condition is under control.

Laser treatment for vaginal atrophy

Some women with genitourinary syndrome of menopause consider vaginal laser treatment, such as RenovaLase, to improve dryness and discomfort. The evidence for laser is still developing and is weaker than for vaginal oestrogen, and laser is not a treatment for lost labial tissue.

Restoring volume to the outer labia

If the outer labia have lost fullness, volume can be restored with hyaluronic acid filler, known as labia puffing, which lasts around 9 to 12 months, or more permanently with labia fat transfer. These treatments add fullness to the outer labia only. They do not enlarge the inner labia and are not suitable while lichen sclerosus is active.

How to Shrink Labia: Can You Make Labia Smaller Without Surgery?

Some people searching for labia shrinking are looking for the opposite: a way to make large labia smaller. Products sold as a “labia shrinking cream” or a cream to shrink the labia minora do not work. The labia minora are folds of skin, and no cream, oil, supplement, exercise or device reduces them. Steroid creams are used for lichen sclerosus, and using them on healthy skin can thin it. Laser and radiofrequency treatments marketed as “non-surgical labiaplasty” cannot remove tissue, as our article on non-surgical labiaplasty explains.

If large inner labia cause rubbing, pain or distress, labiaplasty is the only reliable way to reduce them. Our guide to labial hypertrophy and big labia explains when that is worth considering. Labiaplasty is not a treatment for shrinking labia, and it is not offered to women with active lichen sclerosus.

When to See a Doctor About Shrinking Labia

See your GP if shrinking labia come with any of the following:

• itching, burning or soreness of the vulva;
• white, shiny, thickened or crinkled patches of skin;
• splits, sores or bleeding from the skin;
• pain or tearing during sex;
• the labia or clitoral hood appearing to fuse or stick together;
• a lump, ulcer or area that does not heal;
• a change that has happened quickly or on one side.

These do not mean something serious is wrong, but they need an examination. Lichen sclerosus is very treatable, and early treatment protects the vulva from further change.

Assessment at Centre for Surgery

At Centre for Surgery, women concerned about the appearance of their labia are seen by a GMC-registered surgeon at our CQC-regulated hospital at 95–97 Baker Street. Your surgeon will examine you, explain whether the changes you have noticed look like a normal part of ageing, volume loss in the outer labia or something that needs medical treatment, and talk through the options honestly, including not having treatment. If we see signs of a skin condition such as lichen sclerosus, we will explain this and advise you to see your GP or a vulval specialist before any cosmetic treatment is considered.

Where treatment is appropriate, filler is given in clinic, and fat transfer and labiaplasty are day-case procedures under local anaesthetic, local anaesthetic with sedation or TIVA (total intravenous anaesthesia). The surgeon who assesses you is the surgeon who treats you, our labiaplasty nursing team is all-female, and we only treat adults aged 18 and over.

Frequently Asked Questions

Help for Shrinking Labia in London

If you are worried about changes to your labia, start with your GP if you have itching, soreness or skin changes. If your concern is the appearance of the outer labia or large inner labia, a consultation with a surgeon can explain what treatment can realistically achieve. Find out more about labia puffing at Centre for Surgery.

Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation

References

1. Portman DJ, Gass MLS; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause 2014;21(10):1063–1068. doi:10.1097/GME.0000000000000329
2. Hayes JA, Temple-Smith MJ. What is the anatomical basis of labiaplasty? A review of normative datasets for female genital anatomy. Australian and New Zealand Journal of Obstetrics and Gynaecology 2021;61(3):331–338. doi:10.1111/ajo.13298
3. Kreklau A, Vâz I, Oehme F, et al. Measurements of a ‘normal vulva’ in women aged 15–84: a cross-sectional prospective single-centre study. BJOG: An International Journal of Obstetrics and Gynaecology 2018;125(13):1656–1661. doi:10.1111/1471-0528.15387
4. Lewis FM, Tatnall FM, Velangi SS, et al. British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018. British Journal of Dermatology 2018;178(4):839–853. doi:10.1111/bjd.16241
5. Lee A, Bradford J, Fischer G. Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatology 2015;151(10):1061–1067. doi:10.1001/jamadermatol.2015.0643
6. Lev-Sagie A, Amsalem H, Gutman Y, Esh-Broder E, Daum H. Prevalence and characteristics of postpartum vulvovaginal atrophy and lack of association with postpartum dyspareunia. Journal of Lower Genital Tract Disease 2020;24(4):411–416. doi:10.1097/LGT.0000000000000548
7. Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews 2016;(8):CD001500. doi:10.1002/14651858.CD001500.pub3