Vaginal rejuvenation is a fashionable concept with no strict definition. Yes that’s right, things vaginal are now fashionable. And chances are you’ve got one, or know someone who does.
For many women, the years just before and after menopause come with pelvic, urinary or vaginal problems. Vaginal laxity, pelvic prolapse, poor bladder control, vaginal dryness, sexual pain, or waning sexual response can truly affect how you feel about yourself and your ability to enjoy your life. In medicine, we use “quality of life” questionnaires to measure the affect of such symptoms on health – mental health, ability to work, play, travel, and feel normal and intact as a woman. We hear you loud and clear; if things aren’t right, you have options.
Vaginal rejuvenation sprang onto the medical scene a few years ago, with no formal medical definition. It has since come to mean any variety of procedures and treatments, many with an established record of use for generations, and others with no history, no data, and, therefore, no predictable result. Women with prolapse or using incontinence pads might not know what “prolapse” or “incontinence” truly mean, but all women instinctively understand the notion of vaginal rejuvenation.
For a new mother, vaginal rejuvenation may mean improving pelvic muscle tone, bladder control and vaginal snugness with Kegel muscle exercises in a formal postpartum rehabilitation program of biofeedback (vaginal video games) and pelvic floor electrical stimulation. For a 43 year old tennis- playing mother of 3, it could mean minimally invasive surgery for “exert and squirt” type urinary incontinence (stress incontinence), with “perineoplasty” to restore the perineum (connective tissue between vagina and anus) back to normal, “rejuvenating” bladder control and vaginal snugness to pre- baby condition. Or uterine resuspension, bladder lift, rectum reinforcement (rectocele repair), perineoplasty and a minimally invasive sling for combined prolapse and stress incontinence — what I call “the blue plate special.” Vaginal dryness, poor lubrication and clitoral sensitivity is easily remedied with low- dose vaginal estrogen therapy, treating target area without giving your body a full dose of estrogen.
With “vaginal rejuvenation” in the public lexicon, many women with prolapse or incontinence eagerly seek out a little rejuvenating, but reject the unsexy but accurate labels of “pelvic organ prolapse” or “incontinence.” For women over 50, the risk of pelvic organ prolapse or urinary incontinence are about 5%, and this increases in women who are overweight, or who have birthed children, particularly large babies and long pushing stage of labor. (1,2) A recent study of over 3000 women ages 50- 61 showed 6% with symptomatic, high- grade prolapse. (3) Whether you call it prolapse repair or vaginal rejuvenation, the condition and the treatments are one in the same.
Labiaplasty reduces large inner labia (labial hypertrophy), or restores symmetry to unbalanced labia (labial asymmetry). Vaginoplasty, a mystery term, most often refers to the established perineoplasty operation, which restores vaginal outlet snugness by reconstructing thinning of the perineum caused by childbirth. Hymen restoration involves careful reconnection of the hymen remnants to recreate a pseudovirginal state, most commonly requested by women from cultures requiring virginity at the altar. Clitoral unhooding reduces or removes the skin folds overlaying the clitoris, an inherently risky procedure, given its proximity to the clitoral nerves. G- spot amplification injects collagen into the front vaginal wall. The theory behind such an injection is to create a temporary (as collagen always absorbs and disappears) bump beneath the Grafenberg’s spot, allegedly enhancing sexual response. In 2007, The American College of Obstetrics and Gynecology issued a warning about all of these cosmetic procedures, finding labiaplasty and perineoplasty “may be warranted in properly selected patients,” and reserving endorsement of G- spot enhancement, the ill- defined “vaginoplasty,” and clitoral unhooding, each lacking in the ethical considerations of safety and efficacy required of all surgical intervention.
Vaginal rejuvenation is whatever you need it to be- Kegel exercise to improve vaginal muscle tone, bladder control and orgasm; vaginal estrogen for lubrication and clitoral sensitivity; prolapse operations to resuspend the dropped uterus, bladder and rectum; perineoplasty for vaginal snugness; minimally invasive incontinence procedures or medications for bladders not controlled by Kegel exercise alone; and labiaplasty in carefully selected circumstances, each available as needed to get your pelvic life back on track.
- Lauri Romanzi, MD
| Vaginal Rejuvenation Term | Traditional Medical Terminology |
| Vaginal muscle fitness | Pelvic Floor Rehabilitation |
| Lift a dropped bladder | Anterior Colporrhaphy* |
| Tighten a wide vagina | Perineoplasty |
| Restore the hymen | Hymenoplasty |
| Fix a bulging rectum | Posterior Colporrhaphy |
| Repair a leaky bladder | Urethral Sling |
| Recontour labia | Labiaplasty |
| Restore anal control | Anal Sphincteroplasty |
| Lift a dropped uterus | Uterine Resuspension, aka Hysteropexy |
*Also referred to as “posterior/anterior repair”
Tags: core tone, hysteropexy, kegel, labiaplasty, orgasm, pelvic organ prolapse, perineoplasty, postpartum, preventive health, rejuvenation, uterine resuspension, vaginal rejuvenation, women