Amid the euphoria of childbirth, the congratulations, celebrations and wondrous attention heaped on this new life, one important factor is too frequently overlooked: the physical recovery of the mother.
A natural vaginal birth exerts extreme physical stress on the mother’s birth canal, yet it is generally assumed that she will recover with a little tender loving care and regular cups of tea. The truth is that the impact of childbirth leaves many women with a catalogue of lifelong problems, including slackening of the vaginal wall, dryness, inflammation, incontinence, infection, pain, and loss of sexual confidence. And it’s not just childbirth that affects women in this way. The ageing process alone brings about a natural deterioration of muscle tone in the pelvic region, while the menopause is another time of radical change in a woman’s physiology, which can take a heavy toll on the feeling and function of the vagina.
All too often I meet women who are living with the symptoms of trauma and ageing of the vaginal canal but have come to accept their condition as a fact of life over which they have no control. They also regard plastic surgery as a rather drastic beauty treatment.
The truth is very different.
There are numerous vaginal rejuvenation treatments that can help, without the need for invasive surgery, and I always encourage my patients to pursue them for two very important reasons. The first is to enhance their day-to-day comfort, sexual pleasure and confidence; the second is because, if left untreated, these conditions can cause extreme discomfort and develop into serious conditions like prolapse, incontinence, and infection.
It seems the message is getting through. Vaginoplasty, or vaginal rejuvenation and tightening, is becoming more commonplace. Latest estimates state that more than 5,000 vaginal rejuvenation procedures were performed in the US in 2013 – a 44% increase on the previous year. So what does it involve?
Vaginoplasty, or vaginal rejuvenation and tightening, is becoming more commonplace. Latest estimates state that more than 5,000 vaginal rejuvenation procedures were performed in the US in 2013 – a 44% increase on the previous year.
The problem of vaginal laxity
During the many years I have worked as a gynaecologist and obstetrician, I have met countless women left with significant vaginal canal and pelvic floor muscle laxity after a vaginal delivery. While the tissues of the vaginal wall have some elasticity, they rarely return to their pre-birth condition. As a result the vagina becomes looser, which can affect sexual sensitivity and make a woman feel self-conscious, as well as weakening the pelvic floor, the muscles of which are vital for bladder and bowel control. If damaged, women experience embarrassing leakage of urine (urinary incontinence) during everyday exertions like running, laughing or sneezing.
Particularly traumatic vaginal deliveries can result in very uncomfortable conditions like vaginal relaxation syndrome (VRS), a loss of optimal vaginal structure from being over-stretched, vaginal vault prolapse (when the upper part of the vagina sags into or outside the vaginal canal) and bladder or rectum prolapse.
During menopause, the fall in oestrogen levels, combined with the natural loss of vaginal muscle strength due to ageing (a process called vaginal atrophy), makes postmenopausal women likely to experience urinary incontinence, vaginal prolapse, sexual dysfunction and vaginal dryness – sometimes to a distressing degree and sometimes with additional symptoms like painful intercourse and recurrent vaginal infections.
During menopause, the fall in oestrogen levels, combined with the natural loss of vaginal muscle strength due to ageing (a process called vaginal atrophy), makes postmenopausal women likely to experience many problems.
In the past, women suffered in silence or opted for surgical correction, along with its risks of scar formation and nerve damage. However, recently developed non-surgical interventions now offer a much more accessible, pain-free solution.
Vaginal rejuvenation methods
Bioidentical hormone replacement therapy (BHRT) is a treatment that replenishes oestrogen levels with identical hormones, reversing the effects of vaginal atrophy. Because bioidentical hormones have the same chemical structure as those naturally made by the body, BHRT can restore vaginal health to a premenopausal state, while alleviating other symptoms associated with menopause. BHRT can be administered as a pill, patch, cream or vaginal gel, making it a very convenient solution.
10% of women do not handle oestrogen well and create instead carcinogenic byproducts that can affect their breasts. Women had to plunge blindly into such replacement hoping that they would be fine. Today, we can check your genes and metabolic pathways to make sure that you can handle the natural oestrogens we prescribe safely. This new test is usually available only at practitioners of functional or integrative medicine. It is not covered by insurance yet and costs around USD 1,500. You only need to do this test once in your lifetime in order to minimise your chances of potential problems.
Another method involves stimulating the production of collagen – a protein that gives skin, muscle and connective tissues strength and structure. Collagen production declines with age but a method known as ultherapy, using ultrasound, and gentle laser therapy are now being used to boost collagen production in the vagina. A small device is inserted about six centimetres into the vagina, where it warms the vaginal wall to stimulate collagen production, blood vessel growth and boost vaginal elasticity and moisture. Procedures take about 30 minutes.
While these treatments are still fairly new, research shows they are proving effective. For example, a recent review cited numerous studies in which subjects reported marked improvements, including ‘significant improvement in sexual satisfaction and decrease in urinary incontinence’, without any negative side effects.
A recent review cited numerous studies in which subjects reported marked improvements, including ‘significant improvement in sexual satisfaction and decrease in urinary incontinence’, without any negative side effects.
Collagen-boosting substances can also be applied directly into the vagina by the patient. The AQ vaginal rejuvenation system, for example, uses a group of specialised proteins that switch cell growth on and off. A serum containing these proteins is applied to the affected area with a simple and gentle applicator, stimulating the production of new cells and collagen.
Growth factor production can also be stimulated by a blood component called platelet-rich-plasma (PRP), and this can boost tissue hydration if combined with a substance called hyaluronic acid (HA). In 2016, French researchers looked at the efficacy of PRP and HA injection for vaginal rejuvenation and found it effective at treating sexual dysfunction from vaginal laxity. And pilot studies are producing evidence that PRP and HA injections (into the vaginal wall or clitoris) might be able to improve sexual function in women with painful intercourse, via what is known as an ‘O-shot’ or ‘G-shot’.
No more suffering in silence
Long-term negative effects from the physical trauma of childbirth is not something that women should have to endure. The array of vaginal rejuvenation treatments available today is wider, more effective and more convenient than it’s ever been. As a patient, you can walk into a clinic and walk out less than an hour later with no pain, no required follow-up treatment, down time or complicated antibiotic regime.
The many patients I’ve encountered that have turned to vaginal rejuvenation say it’s helped them reclaim control of their body and regain confidence. If you’ve been suffering in silence with vaginal dysfunction, the time has come to pay yourself the attention you deserve.