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mostly on the labia minor, and sometimes on the labia majora The melanotic macules may be present at other locations within the female genital tract including the cervix and the vagina (and the vaginal opening) They form discolored flat and asymmetric patches on the vulva that are about 1-5 cm in size In both males and females, the macules may be present on the perineum too

the cardiovascular benefits are well-documented