Doctors warn vaginal rejuvenation wastes money, shows no benefit

Lasers may seem like the way of the future — but not yet for your vagina.

Despite talk that vaginal laser treatment can tighten the vagina, improve sexual function and reverse incontinence, there is little evidence to support these claims. In a new article, published Monday in the Canadian Medical Association Journal, a pair of gynecologists asserted that laser devices for vaginal rejuvenation are no more effective than “sham” treatments.

Vaginal rejuvenation surgery encompasses a number of related procedures, but in broad terms refers to clinical attempts to firm up the skin around the vagina or to tighten the vaginal canal.

Vagina rejuvenation has become an “it” operation in recent years, touted by middle-aged celebrities and mothers looking to spice up their sex lives. In 2017, “Real Housewives of Orange County” star Kelly Dodd proudly announced she had a procedure — gushing it changed her life — as did her co-star Braunwyn Windham-Burke two years later.

While a noninvasive laser treatment could start as low as $700, some surgical rejuvenations — such as labiaplasty to reduce the size of the labia minora — resulting in so-called “designer vaginas,” can cost anywhere from $4,500 to $10,000.

Now, some of the procedures are being used to treat genitourinary syndrome of menopause. GSM symptoms include vaginal dryness, painful intercourse and a frequent urge to urinate. However, experts warn getting the procedure could be redundant and a waste of money.

Although such procedures appear to be safe, the paper’s co-authors, Blayne Welk and Erin Kelly, doctors and faculty members of the University of Alberta, noted that no controlled studies have been conducted to assess the efficacy of vaginal lasers for treating GSM.

“Vaginal rejuvenation procedures are being used for the treatment of urinary incontinence and GSM, as well as for less clear indications (e.g., vaginal tightening for better sexual satisfaction), without good evidence that it helps any of these conditions,” the authors noted in the paper.

In a comment to Medscape, Kelly reiterated that expensive and unproven laser procedures are being marketed to women as a viable solution.

“Many women present to the clinic having heard of vaginal laser procedures, having had vaginal laser procedures, or having been told they need vaginal laser procedures,” she told the publication. “My impression has been that these procedures are being marketed to women … without rigorous study.”

One prominent method of rejuvenation called vaginal laser ablation isn’t approved by the United States Food and Drug Administration, with “few high-quality studies” to support the use of vaginal energy devices to treat GSM, according to the authors. Meanwhile, the North American Menopause Society guideline recommends over-the-counter products instead to treat GSM, such as vaginal lubricants or supplementation with vaginal estrogen.

The treatment uses lasers to make tiny scratches on the wall of the vagina, which stimulates the growth of new blood vessels. However, this is only temporary and would require annual sessions because the lack of estrogen during menopause will allow the muscle to atrophy again — which would mean forking out more cash for more treatments.

Of the limited research available, the outcomes recorded have produced “low evidence” of benefit “with a high risk of bias.” Moreover, the FDA has reported that “vaginal burns, scarring, pain during sexual intercourse, and recurring/chronic pain” is known to occur after such treatments.

Welk told Medscape he would like to see information about approved medical devices, including vaginal lasers, made available to the Canadian public — and beyond.

“Health Canada has an online database of approved devices, but no information around the evidence submitted during the approval process is available, nor are the indications for the various devices,” he said.