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JAMA. 1940;114(4):296-303. doi:10.1001/jama.1940.02810040006002.
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The vulva, or the external female genitalia, is under endocrine control and manifests secondary sex characteristics. At birth the labia, the prepuce and the clitoris may appear rather prominent, probably as a result of maternal endocrine stimulation. Similar evidence of estrogenic stimulation may be seen in the breasts and in the internal genitalia of the newborn. These changes disappear rapidly after birth. During infancy and childhood the labia minora and majora remain small, of tissue paper thinness and almost transparent (fig. 1). With the onset of puberty these structures begin to grow rapidly and gradually take on normal adult appearance. The labia minora develop as separate distinct structures, the labia majora become more rounded and fuller and stand out more prominently, and the preputial folds and the clitoris become sharply demarcated. The growth of labial and pubic hair in the typical feminine pattern completes the development of the normal adult


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