By: Paige Nick

What does your vagina look like? Do you think it’s pretty, ugly, yucky, too big, too small, weird? Or have you never really looked at it that closely before?

Women generally don’t talk about their vaginas. Sexual dysfunction in women is taboo in every culture. They don’t even cover it on The Jerry Springer Show, which is saying something.

Now compare the vagina to the penis. Everywhere you look you can read about penile implants and penis enlargements. You can buy Viagra with a prescription, and the black market generic is available on just about any street corner. We even see ads for male impotency between ads for cheese and 4×4’s on TV.

It makes sense when you consider the relationship men have with their penises compared to the one women have with their vaginas. Take the locker room for example. In the men’s room, prancing around naked is ritual. Men’s showers are often communal and even standing at a urinal on a daily basis men can compare size, shape and dimensions. (Although apparently there’s an unwritten law that frowns on staring.)

Women on the other hand rarely see each other naked. And even when we do, what we’ve got is well hidden and quite tricky to get a good look at. Most women have the art of changing inconspicuously down to a fine art. I am able, for example, to put on my costume and take off my bra without ever having to publicly remove my panties or top.

So then where do women get our perceptions of what is ugly, normal or weird in the vagina department? Dr Esther Sapire, a Cape Town sex therapist says, “It’s because the vagina is so well hidden that women have skewed perceptions. Unlike men, we don’t get to see genitals on a daily basis, so it’s left up to our imaginations and the unrealistic standards set by modern media.”

Essentially the only time most women ever see another vagina up close enough to compare to her own, is in pornography. Bearing in mind that these models have been airbrushed and retouched down to the last pubic hair. Hardly the realistic measure we should all be comparing ourselves to. It’s an unattainable goal.

“Most young girls are told not to look at, touch or feel their genitals” Says Dr Sapire “which is why when we eventually do take a look, we often have a negative attitude towards something that is really very natural.”

The first thing Dr Sapire asks her female patients is what they like about their body. Dr Sapire finds that most women just shrug their shoulders and are unable to answer. But when asked what they don’t like about their body, almost all women can instantly supply quite a long list. “It’s sad to see,” says Dr Sapire; “but women are generally very negative about their own bodies.”

Over the years Dr Sapire has consulted with many female patients who complain that their genitalia are abnormal or too long, but when she examines them she finds nothing out of the ordinary. Add to this the fact that she’s never had a case where a male partner has complained about the woman’s genitals, causing her to seek surgery, and we can conclude that it’s us women who are placing these exacting standards on ourselves.

“In fact,” says Dr Sapire; “there’s a multi-billion dollar porn industry based on the very fact that men love to look at female genitals, no matter what their size, shape or colour.”

For women who have issues with the way their genitals look, there are two solutions. With the help of a sex therapist, women can deal with the underlying reasons they feel inadequate or embarrassed about their genitals.

Or these days it’s becoming more common for women to consider cosmetic surgery. Neither route is cheap, quick or easy, but both supply results at the end of the day.


LEE* (*name has been changed)

I can’t remember ever liking my vagina. I always felt that my labia lips were too long. Like what was supposed to be on the inside was more on the outside.

Receiving oral sex was an issue for me. I was always nervous that if a guy got that close to my vagina he might get instantly turned off. So I became a professional in the art of avoiding receiving oral sex.

Then when I was 28 my gynae discovered an irregular cyst on my left ovary. I needed immediate surgery to remove it. After the shock of discovering I needed surgery “down there” a thought crossed my mind. Maybe while they were in the “neighborhood”, they could do something about my labia lips?

The procedure is called a Labial Reduction. My doctor and I discussed the pros and cons of the op and I decided to go through with it.

The fact that medical aid would cover the anesthetic and hospital room and all other costs related to the necessary removal of my cyst, meant that I would only have to cover the actual labial reduction. I even had a good reason for taking sick leave. No boss (especially male) is going to question ten days off after ovarian surgery. All these facts made the decision an easy one to make.

I came to in the hospital room, groggy and sore. The surgery had been a success and the cyst was benign (I always knew it would be). Two days later I left the hospital and began the unglamorous ten-day healing process. Walking and going to the toilet were both unpleasant experiences, and driving was out of the question, but it was nowhere near as painful or gruesome as I had imagined.

So ten days, two packs of Miprodol and three boxes of boogey board-sized sanitary towels later, the stitches had dissolved, the swelling had gone down and I was ready to take a look at my new labia. It was beautiful. It’s neat and tucked away now, the way I always wanted it to be.

I’ve never doubted that I made the right decision having the surgery. I still have issues with my body, which I don’t think will ever be perfect, but I’m definitely more sexually confident than I was before.

The interesting thing is that I don’t think I would ever consider having any other kind of cosmetic surgery done, like a boob job or anything like that. I mean, I don’t think I have perfect boobs, but the difference is that I don’t feel like my breasts are abnormal or weird looking, which is how I felt about my vagina before the surgery. It wasn’t a simple matter of wanting them bigger or smaller (as with a boob job) it was a matter of feeling really embarrassed about how my genitals looked, and needing to do something about it to be able to enjoy a healthy, normal sex life.


Dr Aneen Van Der Merwe is a Cape Town Gynaecologist who’s performed a number of cosmetic genital procedures over the last four years. In her experience Labial Reduction is the most common procedure. Undertaken by women who feel their labial lips protrude too much, and want to have them shortened.

Although this is mainly done for cosmetic purposes, there are cases where medical reasons come into play. According to Dr Van Der Merwe: “In extreme cases women with larger labial lips find it uncomfortable to wear tight jeans, sit for long periods of time or enjoy riding a bicycle. We often see avid sportswomen like tri-athletes or horse riders enquiring about a Labial Reduction.”

Other genital procedures include;

Vaginoplasty is requested by women who’ve had natural childbirth (often more than once). The procedure tightens the vagina, for the purposes of a more enjoyable sex life.

Hymenoplasty is reconstruction of a woman’s hymen, “revirginising” her. Often requested by ultra-religious Moslem girls who must be proven virgins before they can marry. It’s also undertaken by women who’ve lost their virginity through rape or by women who are marrying for a second time and want to start a new life with a fresh slate.

Labial Refashioning is all the rage in America. Women show a plastic surgeon reference of what they want their genitals to look like. Some plastic surgeons even have a selection of “looks” on their books for patients to choose from.

Vulvar Lipoplasty is the removal of fat from the upper part of the labia. Lipo-sculpturing removes the fatty bulges of the area resulting in what some women feel is a more aesthetically pleasing contour. Most of these procedures are purely cosmetic and have no medical motives.

If any of these procedures appeal to you, Dr Van Der Merwe strongly recommends that you discuss it with your partner first. So you can both agree on what you hope to achieve with the surgery, and your reasons for having it.

And Dr Sapire cautions; “Often couples have high expectations of what the surgery can do for their sex life, and then run the risk of being disappointed when they discover that either the sex is still much the same, or their problems actually extend further than the bedroom. More often than not sexual issues have their core in psychology, not anatomy.”

Once you’ve laid down your expectations of what you hope to achieve with the surgery, there are also other factors to consider. Besides the fact that medical aid doesn’t cover cosmetic procedures, any surgical procedure carries a risk.

“With a vaginal tightening the vagina can often end up too tight, resulting in recurring urinary infections and pain during sex.“ Warns Dr Van Der Merwe.

As far as the Labial Reduction is concerned, Dr Van Der Merwe also cautions that once the labia lips have been cut back, the clitoris may protrude on some women. Which can be uncomfortable. And if too much of the Labia Minora (the lips) is removed, the vulva can actually look more exposed and “worse” than it did before the operation.

And of course, there is a four to six week recovery period, before you can resume sex. Which is enough to put anyone off surgery if they aren’t a hundred percent sure they need it.


Depending on your choice of hospital (and whether you want a private room or are happy to be in a general ward) the cost of a procedure like a labial reduction is somewhere in the region of R10 – 15 000, which includes the operation, anesthetic and a one or two night stay in hospital.

Websites and phone numbers if you’re interested in finding out more:
South African Sexual Health Association (SASHA) – 0860 100 262
Sex Therapist – Dr Esther Sapire – 021 480 6342
Gynaecologist – Dr Anneen Van Der Merwe – 021 4224125
Physiotherapist – Dr Ruth Katzman –  0828648232
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