Many women request reduction of the labia minora for functional, aesthetic and social reasons. The demand for this procedure is not only in the US but all over the world. Labia minora hypertrophy can be congenital or acquired by chronic irritation, exogenous androgenic hormones or constant stretching by mechanical means. Large labia minora can cause inflamation, poor hygiene, interference with sexual intercourse and also with many athletic activities. Today many women are more aware of their own genital appearance because of pattern of shaving and the availability of published nude pictures in magazines, movies, videos and on the internet. Abnormally large labia lead to self-consciousness sexually and low self esteem. Some worry that some may judge the person as engaging in masturbation. However, in women urinary frequency is quite common and the constant mechanical stretching due to wiping could cause some hypertrophy indeed. More on frequency later. Here would like to discuss that there are at least three methods of reduction. One mainly removes the extra tissue at the edge of the labia leaving the same shape, but thus getting rid of a lot of the pigment at the edge. Some women like that as they like to have the pink color to the labia minora. Other methods involve wedge resections, however it may lead to a shortened labia with some tightness. Another method is removing excess labia mucosa from the midsection lenghtwise which preserves the edge and the pigment. Whichever method one chooses, if done by a competent surgeon has few complications and a short recovery and can be done on outpatient basis under sedation anesthesia. However, one must discuss the various methods with the doctor and choose the one best suited to the outcome the patient would like. There is no room here in being too embarrassed to discuss any alternatives as it is very important to feel good about ones sexuality. Dr. Helen Colen