Vulvar Developmental Stages During Puberty: A Systematic Review

Article Article scientifique Revue de la littérature Vulvar Developmental Stages During Puberty: A Systematic Review eng 2025-06 author Casalino Francesca Medical School, Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: francesca.casalino@hug.ch. 926444 author Moussaoui Dehlia 0000-0002-6987-4916 Department of Women, Children, and Adolescents, Geneva University Hospitals, Geneva, Switzerland. 642525 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Brockmann Céline Denise Medical School, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 134627 Structure enseignement (ENSI) author Crofts Victoria 0000-0002-4488-2012 Department of Women, Children, and Adolescents, Geneva University Hospitals, Geneva, Switzerland. 646382 author Abdulcadir Jasmine 0000-0001-6245-9181 Department of Women, Children, and Adolescents, Geneva University Hospitals, Geneva, Switzerland. 796507 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Yaron Michal Department of Women, Children, and Adolescents, Geneva University Hospitals, Geneva, Switzerland. 668428 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 313-319 10.1016/j.jpag.2025.01.002 39798782 1083-3188 https://linkinghub.elsevier.com/retrieve/pii/S1083318825000026 Study objective: Puberty is associated with important changes in secondary sexual characteristics, but the changes occurring in female external genitalia are not thoroughly described. The aim of this systematic review is to summarize and assess the current scientific knowledge regarding vulvar changes and development during puberty. Methods: PubMed, Embase, Web of Science, and Cochrane were searched using keywords related to "puberty," "vulva," and "morphology." The inclusion criteria were observational studies describing vulvar development in individuals between the ages of 8 and 16 years. The outcomes of interest were quantitative and/or qualitative descriptions of the vulva, including anatomic, physiological, and histological changes. Results: Of the 1658 articles screened, 10 were included. The mean clitoral glans diameter increases during puberty, as does the length of the clitoral hood. The clitoral hood changes to become more retractile and rugose. The inner labia width and length increase throughout puberty, and the development of the inner labia varies between individuals, with labial asymmetry being a common characteristic. The most frequent hymenal configuration found during puberty is the crescentic form, and features such as hymenal mounds, longitudinal intravaginal ridges, and most notches are physiological. Conclusion: Reliable data on pubertal development of the external female genital organs are scarce. Future research is needed to provide more precise data to help categorize vulvar development into stages. A detailed description of vulvar maturation into sequential stages throughout puberty (as done by the Tanner scale for the male homologous structures) can increase knowledge of its morphologic diversity and help reach clinical consensus on the nature of pathologic variants. In addition, better knowledge of vulvar diversity is important to both health care professionals and individuals and may empower and promote self-esteem. Anatomy Clitoris Growth & development Hymen Puberty Sex characteristics Sexual development Vulva Adolescent Child Clitoris / anatomy & histology Clitoris / growth & development Female Humans Puberty / physiology Vulva / anatomy & histology Vulva / growth & development Genitalia Dewey 618 “Fondation privée” Geneva University Hospitals 58 Département de pédiatrie, gynécologie et obstétrique 223 false 1450 Vulve, clitoris et violences sexuelles 1067 515 Recherche en infectiologie pédiatrique et en pédiatrie générale 853 Journal of pediatric & adolescent gynecology 38 3 fb01295d-738c-45ca-b714-dd8171a47fc2 Article (Published version) Public 1-s2.0-S1083318825000026-main.pdf 699905 application/pdf CC BY-4.0 962098ad888c1b79077336d920aef7bcd2e62f216045edaeb994b31ab9355e61 b59dac94-42db-4901-9921-8b06c82ea0a7 Appendix Public 1-s2.0-S1083318825000026-mmc1.docx 29964 application/vnd.openxmlformats-officedocument.wordprocessingml.document Search strategy used for each database + Johanna Briggs Quality Assessment + PRISMA Checklist d28e1267cff9edeb3e39a5b00f74a55447d45110dcea688c4100c6e280c57701 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Casalino, Francesca