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If you're dealing with painful sex or other sexual dysfunction issues—or if you're just into the idea of having a more enjoyable sex life—the recent trendiness of vaginal laser rejuvenation might seem like a magic wand.
But the FDA warns that vaginal rejuvenation surgeries aren't just bogus—the procedure is actually dangerous. Here, everything you need to know about the vaginal rejuvenation process.
What's the idea behind vaginal rejuvenation, anyway?
First thing's first: Your vagina is an elastic muscle. You know this because, even if you haven't had a baby, you understand the basic anatomical magic that has to get something the size of a watermelon out of a hole the size of a lemon. Like most elastic things, though, your vagina can lose some elasticity. (Related: 10 Things to Never Put In Your Vagina)
FWIW, it's not the frequency (or lack of…) sex that can change how tight your vagina is. There are really only two things that change the size of your vagina: age and childbirth. Childbirth, for obvious reasons. And "as we age, the levels of our hormones decline, which can cause a decrease in the strength of the muscle and surrounding connective tissue and, therefore, the tightness of the vagina," explains Anna Cabeca, M.D., author of The Hormone Fix. When the vaginal walls thin due to less estrogen, which can make it feel like there's been a change in diameter, that's called vaginal atrophy.
For some women, that looser feeling is enough to make them wish they could go back to their pre-childbirth (or just more youthful) bits. And that's where vaginal rejuvenation—the goal of which is to decrease the average diameter of the vagina, mainly for sexual reasons—comes in.
What does the vaginal rejuvenation process entail?
While there are some surgical options, most people (ahem, the Real Housewives) are referring to the use of non-surgical technology when they talk about vaginal rejuvenation. "Vaginal rejuvenation is like a facelift for the vagina," explains Anika Ackerman, M.D. a urologist based in Morristown, NJ. "A vaginal probe—CO2 lasers and radio frequency devices are the two most common types of technology that are being used—is inserted and the energy is applied for anywhere from five to 20 minutes."
That energy causes microdamage to the vaginal tissue, which in turn tricks the body into repairing itself, explains Dr. Ackerman. "New cell growth, collagen, and elastin formation, and angiogenesis (formation of new blood vessels) at the site of injury lead to thicker tissue, which makes the vagina feel tighter," she says.
These procedures are in-office, relatively painless, and quick. Sometimes patients report a local warming sensation (not enough to warrant the use of anesthetics), and "anyone who's had intense pulse light therapy [for sun spots, redness, age spots, or broken blood vessels] would have an idea of how it would feel in the vulva and vaginal area," says Dr. Cabeca. (Related: The Anti-Aging Benefits of Red Ligh Therapy)
"A slight stinging, very light burning sensation could be felt during the procedure," she adds. Although "you should be able to resume normal vaginal activity within 48 hours," says Dr. Ackerman.
So what are the risks associated with vaginal rejuvenation?
So here's the catch. While these "energy-based devices" (i.e., lasers), destroy and reshape vaginal tissue, this doesn't actually make your vag "tighter," per se, says Adeeti Gupta, M.D., a board-certified gynecologist and founder of Walk In GYN Care in New York. Instead, the laser procedure causes your below-the-belt tissue to become inflamed, creating scar tissue. "This can look like a tightening of the vaginal canal," she says.
The idea is that the vaginal rejuvenation process will help boost sexual desire and sexual function, but there's just one problem: These claims are probably all BS, says Dr. Gupta. (And the same goes for this product, FYI: Sorry, This Exfoliating Herbal Stick Won’t Rejuvenate Your Vagina)
What's worse, some researchers have raised concerns that tissue damage from the laser may actually increase urogenital pain and pain during sex, and point out that we have no idea of the effect of the laser on the rectum, urethra, and bladder. And other women "complain of scarring and pain after treatments, and that can be life-changing in a horrific way," says Felice Gersh, M.D., an ob-gyn and the founder and director of the Integrative Medical Group of Irvine, CA.
Plus, the FDA has officially warned that the vaginal rejuvenation is dangerous.
If that wasn't enough to convince you, in July of 2018, Food and Drug Administration Commissioner Scott Gottlieb, M.D., issued a strongly worded warning about the vaginal rejuvenation process. "We've recently become aware of a growing number of manufacturers marketing 'vaginal rejuvenation' devices to women and claiming these procedures will treat conditions and symptoms related to menopause, urinary incontinence, or sexual function," Dr. Gottlieb wrote on behalf of the agency. "These products have serious risks and don't have adequate evidence to support their use for these purposes. We are deeply concerned women are being harmed."
"In reviewing adverse event reports and published literature, we have found numerous cases of vaginal burns, scarring, pain during sexual intercourse, and recurring or chronic pain," writes Dr. Gottlieb. Yikes.
Dr. Gupta adds that, for what it's worth, in the majority of cases, the treatments are "mostly harmless,", but they can cause scarring and burns if the treatment is not performed properly or if someone has an allergic reaction, she explains. Considering there are no proven benefits, even the smallest risk seems not worth it.
What's the verdict for your vag?
Of course, every woman wants to keep a healthy and functional vagina. But "the bottom line is that the vagina, like all structures in the body, will age and look and work less well as time passes," says Dr. Gersh. Pelvic floor exercises are a better place to start in terms of improving the sensation and function of the vagina, says Dr. Cabeca, while certain hormones can positively affect the vaginal muscles, collagen, and connective tissues. (Related: Pelvic Floor Exercises Every Woman (Pregnant or Not) Should Do)
But if you're actually suffering from medical issues like vaginal prolapse or incontinence, "a qualified gynecologist is needed to help repair the damage surgically, prescribe a solution, or recommend pelvic floor physical therapy," adds Dr. Gersh. "Medical devices for vaginal rejuvenation are not yet ready for prime time."