Vaginal tightening is the name of any procedure that aims at restoring the tightness of the muscles and tissues of the vagina.
The term vaginal rejuvenation is sometimes used to indicate vaginal tightening procedures but has a broader meaning and is often used to indicate any “designer vagina” or cosmetic female genital treatment, both medical and surgical.
Giving birth, aging, or fluctuation in weight, can have a negative impact on sexual intimacy such as decreased sensation and pleasure during sexual intercourse.
Childbirth and especially multiple pregnancies stretch the tissues and the muscles of the vagina, which then never return to their original state.
Before menopause, the ovaries produce estrogen, a hormone that also stimulates the tissues in the vagina to keep producing and renovating cells, keeping it elastic. With the decrease in estrogen production, the vaginal walls become thinner and less elastic; there may also be vaginal dryness, itching, burning or other symptoms associated with vaginal atrophy.
Gaining weight can stretch tissues and make them sag when the weight is lost, not just the skin, your vaginal canal, muscles and the external genitalia are included.
Sexual gratification is also the result of the friction caused by penetrative sex on the vaginal walls and these changes all lead to decreased pleasure during penetrative intercourse.
Non-surgical vaginal tightening procedures
There are surgeries to address vaginal laxity and restore the tightness of the vaginal canal, but in this article we’re going to focus on all non-surgical, minimally and non-invasive methods of vaginal tightening and rejuvenation.
Although lasers and radiofrequency medical devices have been studied and are FDA-approved for several applications such as face skin tightening, their use for vaginal tightening is not FDA-approved due to the lack of data and studies on their safety and effectiveness. Nevertheless, they are known to promote the production of dermal proteins such as collagen and elastin, to increase blood vessel formation which will bring more nutrients in the treatment area stimulating the healing process, and to increase the density of small nerve fibers and for these reasons some physicians use them off-label for vaginal rejuvenation purposes.
Non-invasive vaginal tightening may not benefit patients with significant laxity of the vaginal canal for whom a vaginoplasty with surgical tightening of the vagina is indicated.
CO2 Laser Vagina Rejuvenation – FemiLift®, MonaLisa Touch®
Vagina rejuvenation with the use of a CO2 laser usually requires three or four, 5- to 15-minute sessions spaced 4-6 weeks apart. The fractional CO2 laser has a special probe designed to be inserted into the vagina. The thermal energy from the laser stimulates the contraction of the existing collagen fibers, the production of new collagen and the formation of new capillaries and blood vessels, which result in firmer and tighter vaginal walls. Laser vagina rejuvenation may also alleviate vaginal dryness and stress urinary incontinence (SUI). After the treatment session, which is performed in an outpatient setting and which does not require anesthesia, women can return to their daily routine but should avoid sexual intercourse for the first few days.
Radiofrequency Vagina Rejuvenation – ThermiVa®
Vagina rejuvenation with the use of a radiofrequency device works by applying radiofrequency energy to the tissues causing them to heat deeply without causing superficial injury, which stimulates collagen production and tissue tightening. The treatment is carried out in an outpatient setting, does not require anesthesia or pain medications, has no downtime and even sexual activity can be resumed immediately after treatment. Radiofrequency vagina rejuvenation requires 3 to 5 treatment sessions, which take 15-30 minutes, once weekly or over the course of a few months in order to be effective, even though some patients report improvements since the very first treatment.
In all studies conducted, radiofrequency showed very promising results and was a painless and comfortable noninvasive treatment leading to improvement in self-reported vaginal tightness and lubrication, increased sensitivity and sexual satisfaction, and reduce stress urinary incontinence. Nevertheless, it may not be indicated in women whose vaginal laxity is caused by extensive damage of the pelvic muscles due to childbirth for which surgery may be a better choice.
Other minimally invasive techniques for vaginal tightening
Among the other techniques used to tighten the vagina there are:
- Erb:YAG Laser (IntimaLase®), which is a type of laser that does not cause superficial injury, while creating rapid heat pulses that are absorbed deeply in the tissues and result in tightening.
- Lipofilling, also known as fat grafting, is a minimally invasive technique that uses the patient’s own fat cells as filling material to restore the volume lost in vaginal atrophy.
- Hyaluronic acid, used as filling material to restore the volume lost, but unlike the lipofilling it is a temporary treatment.
- Platelet Rich Plasma (PRP), uses the growth factors contained in the patient’s blood and extracted by drawing a small amount of blood from the patient and then processing it with a centrifuge; these growth factors stimulate tissue repair and regeneration, blood vessel formation and reduce inflammation.
- Local and Systemic Hormone Replacement Therapy (HRT). In menopausal women, vaginal dryness, pain and vaginal atrophy are caused by the changes in their hormone levels, in particular the decrease of estrogen production by the ovaries. For this reason, local and systemic estrogen preparations may be used to improve the symptoms.
- Kegel Exercises, which are exercises that help strengthen the pelvic floor muscles and improve some symptoms caused by their weakening due to aging, pregnancy, childbirth or being overweight. Kegel exercises can be done anywhere at any time and should be performed three times a day for a few sets in order to achieve results.
Combination treatments may improve the results, such as lipofilling + PRP which increases the survival rate of fat cells, or surgical + nonsurgical procedures done both pre-op and post-op.
Cost of nonsurgical vaginal tightening
The cost of treatment varies depending upon the chosen doctor and clinic, the specific device used and the country where you’re undergoing treatment. Clinics usually sell 3-session packages which provide good savings when compared to the cost of single treatments.
On average in the USA, the price for 3 sessions of laser vaginal rejuvenation (FemiLift) is 2,500-3,500 USD and for 3 sessions of radiofrequency vaginal rejuvenation (ThermiVa) is 2,000-3,000 USD.
In the UK, the average price for 3 sessions of laser vaginal rejuvenation is 2,500-3,000 GBP (3,200-3,800 USD) while the price for 3 sessions of radiofrequency vaginal rejuvenation is 1,800-2,400 GBP (2,300-3,100 USD).
In Thailand, the average price for 3 sessions of laser vaginal tightening (FemiLift) is 60,000-80,000 THB (1,900-2,550 USD) while the cost of 3 sessions of radiofrequency vaginal tightening (ThermiVa) is 40,000-60,000 THB (1,250-1,900 USD).
Take home message on nonsurgical vaginal rejuvenation
- Nonsurgical vaginal tightening procedures may help improve vaginal tightness, increase sensitivity and sexual pleasure, alleviate stress urinary incontinence and pain, and improve lubrication when symptoms are mild to moderate. They will not be able to address severe conditions for which surgery or other treatments may be more indicated.
- Several medical associations such as the American College of Obstetrician and Gynecologists (ACOG), The North American Menopause Society (NAMS) and the FDA are critical of these devices saying that long term studies are needed to assess the long-term safety and effectiveness of nonsurgical vaginal tightening procedures. This said, more and more studies are being conducted and satisfaction surveys among patients all seem to point to the same direction: they are safe procedures which improve symptoms and satisfy the patients.
- Go to an experienced provider and avoid SPAs offering this treatment. Knowledge and experience are needed for optimal outcome. Moreover, symptoms may be caused by other conditions requiring treatment, from infection to cancer; for this reason, having a professional conduct a consultation is critical to avoid both inappropriate treatment and overlooking serious symptoms and conditions.
- Radiofrequency treatment of vaginal laxity after vaginal delivery: nonsurgical vaginal tightening.
LS Millheiser, RN Pauls – Journal of Sexual Medicine, Sep 2010
- Fractional CO 2 laser treatment for vaginal laxity: A preclinical study.
TR Kwon, JH Kim – Lasers in Surgery and Medicine, Sep 2018
- Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90° and 360° Scanning Scopes: A Pilot Study & Short-term Results.
MS Lee – Laser Therapy Journal, Jul 2014
- The use of pulsed CO2 lasers for the treatment of vulvovaginal atrophy.
S Salvatore, S Athanasiou – Current Opinion in Obstetrics and Gynecology, Dec 2015
- Radiofrequency: An Update on Latest Innovations.
SA Malerich, AH Nassar – Journal of Drugs in Dermatology, Nov 2014
- Vaginal rejuvenation: From scalpel to wands.
SA Desai, G Kroumpouzos – International Journal of Women’s Dermatology, Jun 2019
- Female Cosmetic Genital Surgery – Concepts, Classification, and Techniques.
C Hamori – Thieme, 2017
- American Society of Plastic Surgeons
- American College of Obstetrician and Gynecologists (ACOG)