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and it’s more about how the woman feels.” Dr Nataly Atalla, a senior consultant gynaecologist specialising in fertility, reproductive medicine and menopause, adds, “Vaginal laxity is when the vagina becomes loose, has no tone, hangs below and becomes wider, so the normal feel that women are used to becomes very different. It’s commonly associated with other symptoms related to failed pelvic floor support like vaginal prolapse and urinary control problems such as frequency, urgency or stress incontinence/leaks.” Much like other areas such as the face, with age brings collagen and elastin loss to the vaginal canal, says Dr Lakhani, which will contribute towards laxity. However, she says that childbirth and the menopause significantly accelerate this. Dr Atalla emphasises, “Childbirth is the first related cause of vaginal laxity. Following childbirth, women commonly suffer from muscle weakness, pelvic floor muscle tone loss and looseness which, if not recovered, can cause weak pelvic floor support. It can also influence organs around and supported by the vagina to hang down loose or sink. These organs include the uterus, bladder or bowels, causing a different effect on their feeling inside and down below. It can also impact these organ’s functions, such as bladder or bowel function and, essentially, sexual sensitivity, function and satisfaction.” The second main trigger for vaginal laxity occurs with age from around the mid 30s onwards, adds Dr Atalla. Aesthetics interviews three practitioners who “This is a crucial factor far underestimated and falsely to only happen at or after menopause, while explore the causes of vaginal laxity and their assumed in fact all female ageing is more relevant to hormones. tips for treatment using radiofrequency Hormones start changing as women start to enter the pre or perimenopause stages. Women exhibit changes Designer vagina. It has a ring to it, doesn’t it? It is a term that in both ovarian hormone levels and balance changes, which includes has been frequently used by the media to describe the cosmetic oestrogen, progesterone and testosterone.” surgical intervention of the female genitalia and, more recently, She adds, “So, even women who have never had children will find the non-surgical rejuvenation alternatives such as dermal fillers, that their vagina will begin to feel different, with tone, moisture, and platelet-rich plasma, chemical peels, and energy-based devices. sensitivity changes and it will become devitalised over time. This is However, contrary to popular belief, practitioners treating this related to loss of elastin and collagen, with loss of sensitivity, normal area say patients very rarely present to clinic with requests of texture and blood flow in the vagina and its underlying tissues.” a ‘designer vagina’ and their concerns usually run deeper than improving just the appearance. Dr Atalla adds that patients may present with a perceived enlargement Aesthetic practitioner Dr Shirin Lakhani has worked in women’s or hypertrophy of the labia, with surrounding vulva and labial skin, and health, as a GP, and holds a Diplomate of the Royal College of tissues may become atrophic and wrinkled. This can change not only Obstetricians and Gynaecologists. She says that when it comes to the feel but the appearance of the vulva and labial area. the intimate area, the main reason women present is to address She says, “Exactly what happens to your face also happens down issues with their functionality. “I would say that for 99% of my below – dryness, skin wrinkling and loosening – so practitioners need patients the motivations to seek help are to improve discomfort, to educate patients that this is all part of hormone changes and ageing sexual function, incontinence and the overall feeling they have and discuss how we can improve it.” down there, rather than their aesthetic appearance,” Dr Lakhani Symptoms can directly impact quality of life, such as mental health and explains. For many patients, these issues stem from vaginal laxity, relationships and it is an underreported condition, practitioners note.1 which according to practitioners interviewed, can be successfully managed using radiofrequency (RF) technology – a familiar tool to Tips for consulting patients many aesthetic practitioners. All practitioners interviewed agree that these are sensitive patients and there needs to be a large focus on education. In the consultation, Understanding vaginal laxity as with other treatments, practitioners also need to include a patient Aesthetic practitioner and former surgeon Miss Mayoni Gooneratne history, evaluation of the symptoms and examination to make a correct has a PhD in the neurology and control of the bowel and pelvic floor, diagnosis and treatment plan. and specialises in feminine health. She defines laxity as a symptomAccording to practitioners, a consultation of around 45 minutes is led problem that women describe when their vagina feels looser than normal, and Dr Lakhani highlights that patients should have the option normal. She states, “Vaginal laxity is not a physiological measurement to come back if needed. Miss Gooneratne adds, “For this area, the
Treating Vaginal Laxity with Radiofrequency
Reproduced from Aesthetics | Volume 7/Issue 5 - April 2020
