Love Your Labia: A Pelvic Physio’s Take on What’s Normal (and Why That Question Matters)
When you live with endometriosis or persistent pelvic pain, it’s easy to feel like your body is working against you- especially when people don’t often discuss the pelvic area. And then you get referred to Pelvic Physiotherapy, and have no idea what to expect!
Many clients arrive at their first Pelvic Physiotherapy session feeling anxious. Some are scared it’s going to hurt and others are worried that something about their vulva, labia, or vagina isn’t “normal.” I’ve lost count of how many people have nervously asked: “Is it okay down there?” or whispered, “Sorry, I haven’t waxed…”
So let’s discuss this and clear things up- with kindness, facts, and zero shame.
First: There’s No One Way a Labia Should Look
Your labia are the soft folds of skin surrounding the vaginal opening. You have:
Labia majora: the outer folds
Labia minora: the inner folds
Some labia minora are tucked in, and others extend past the outer lip. One side may be longer than the other. Colour can range from light pink to deep brown, even purplish hues- especially during menstruation or pregnancy. All of this is completely normal and variation is common.
Labias are like fingerprints, smiles, eyes, and bodies, all different and unique to you.
Pelvic Pain and Body Image: A Complicated Relationship
Endometriosis can distort how you feel about your body- especially when pain is intimate, cyclical, or hard to explain. If you've ever felt disconnected from your pelvic area or ashamed of how it looks, you’re not alone and this is a common feeling that deserves validation.
Medical trauma, repeated internal exams, comments from past partners, or even social media can contribute to a deep sense of self-consciousness. With a rise in how bodies, and specifically vulvas, are portrayed on the internet, it is easy to see how people can develop a confused relationship with their own vulva and body.
As a pelvic health physio, I see this emotional layer just as often as I see tight muscles or bowel symptom, and it is all related. For example, imagine coaching a patient on how to identify their pelvic floor muscles and learn how to move them (contract and relax). But if they are worried or ashamed of how their vulva, including their labia, look, this can be tricky. They may find it difficult to connect with the area or feel uncomfortable relaxing it.
Vaginal Exams: You Deserve Consent, Choice, and Control
A lot of people feel nervous about vaginal assessments- especially if they’ve experienced medical invalidation, past trauma, or simply don’t know what to expect. All of this is valid. It is complicated going through life with a disease that impacts the pelvis, and sometimes requires transvaginal ultrasounds or vaginal examinations to gain more information or as part of treatment.
Here’s what I want you to know:
You don’t have to have a vaginal exam to start pelvic physio
You can pause, stop, or change your mind at any point
We will always explain things first, and check in throughout
You can bring a support person, use a mirror, or just talk things through
You are in control. Always. It is crucial to the success of Physiotherapy, that you feel comfortable, as this will reflect in how your muscles and nervous system behave.
So… Why Do We Even Talk About Labias in Physio?
Because when you understand your pelvic area, not fear or avoid it, it’s easier to manage symptoms, seek support, and reconnect with your body on your own terms.
We talk about:
Labial irritation (often from tight clothing, different soaps, shaving, or infections)
Pelvic muscle tension (which can contribute to painful sex, passing urine or stool, or periods)
Vulval sensitivity (especially for those with persistent pelvic pain and/or endometriosis)
And just as importantly, we talk about what’s normal, what’s not dangerous, and what’s totally okay to talk about.
Final Thoughts: Reclaiming Confidence, One Conversation at a Time
If you’ve been taught to feel embarrassed, ashamed, or confused about your labia- you’re not alone. But you are allowed to feel safe and at home in your body again.
So here’s your gentle reminder:
✨ There is NO normal- your labia is as unique as your smile.
✨ You don’t need to look a certain way to be worthy of care.
✨ You don’t have to be waxed, shaved, or “presentable.”
✨ Your labia, your vagina, and your story- are valid.
At Matilda, we believe in whole-person, trauma-aware care. That includes how we talk about bodies, how we manage pain, and how we treat each other.
Your body is not broken. It’s communicating. And we’re here to help you listen with compassion- not judgment.
Want to Explore More?
Want to see real examples of normal? Visit The Labia Library
Want to learn about the movement towards normalising vulvals- Have a look at Comfortable In My Skin
You're not too much. You're not alone.
And you’re absolutely normal 💛
FAQ:
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Yes! It’s very common for one side of the labia to be longer or shaped differently. Just like breasts, ears, or feet- asymmetry is natural.
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Absolutely. A Pelvic Health Physiotherapist can assess for muscle tension, nerve irritation, or skin sensitivity that might be contributing to pain or discomfort. We can also refer on to other health professionals who may help for different reasons and in different ways.
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Is it normal to feel nervous about a vaginal exam?
Yes- feeling anxious before a vaginal or internal pelvic exam is very common, especially if you’ve had pain, trauma, or negative healthcare experiences. A supportive Pelvic Health Physiotherapist will talk you through the process, explain every step, and always respect your comfort, privacy, and consent.
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Endometriosis doesn’t directly change the labia, but it can lead to muscle tension, nerve sensitivity, or pain around the vulva due to chronic inflammation and protective holding patterns. This can cause burning, stinging, or irritation- especially with tight clothing, exercise, sitting, or intimacy. A Pelvic Physiotherapist can help assess and treat these symptoms.