The normal vulva in medical textbooks

Abstract

When a healthy woman expresses concerns about her vulva, the doctor's response should be informed by clinical knowledge. For many doctors, accumulation of such knowledge would have begun with undergraduate teaching and medical textbooks. The aim of this study is to examine the information on female genital morphology in medical textbooks. A total of 59 gynaecology and anatomy textbooks were searched for information on the dimensions of vulval constitutent parts. No textbook gave measurements for all vulval structures. Vaginal length was reported in 21/59 textbooks, clitoral size in 15/59 and labia minora in 1/59. Where measurements appear, they suggest narrower ranges than recent reports. Information of vulval morphology is scanty and inaccurate in medical textbooks. The general lack of professional resources means that doctors may consciously or non-consciously rely upon personal experiences and popular culture to form their opinions, as do their patients.

Post‐coital genital injury in healthy women: A review

“…However, the literature is inconsistent regarding the description and definition of “normal” size and distribution. A study published in 2013 examined information on female genital morphology in medical textbooks and identified the absence of accurate and consistent descriptions of normal female genitalia (Andrikopoulou et al, ).…”

Measurements of a ‘normal vulva’ in women aged 15–84: a cross‐sectional prospective single‐centre study

“…Accurate and detailed descriptions of the external female genitalia are rare and thus reproducible definitions concerning the ‘normal’ appearance of the vulva are still being debated. Even most medical textbooks lack information of vulvar morphology . In defining a ‘normal’ appearance today, we are using limited data from the beginning of the 20th century.…”

Female genital cosmetic surgery: a cross-sectional survey exploring knowledge, attitude and practice of general practitioners

“…GPs can reassure women, but only if they themselves are confident of normality. As depictions of genital anatomy are sparse in the medical literature, 24 it is not surprising that only 75% of GPs were confident in evaluating normality of female genital anatomy.…”