Has the promise of tighter, more youthful lady parts caught your attention? Tempted to try vaginal tightening therapy, vaginal restoration, or feminine rejuvenation as vaginal laser therapy has been nicknamed? Have you seen the social media posts claiming freedom from painful sex, leaking urine, or a dry, itching vagina in just three short, painless treatments?
This second installment of the “Health or Hype?” sheds light upon vaginal laser therapy- the latest anti-aging technology being sold to women. Savvy marketing campaigns and unscrupulous women’s health providers are convincing women to shine powerful lasers on their most delicate and sensitive nether regions, all in search of the feminine fountain of youth. But is vaginal laser therapy safe? Does it work? How long do these reported magical results last? Unfortunately, shining a light on available research does not provide clear answers for women looking for help.
What Is Vaginal Laser Therapy?
Gynecologists had a laser-bright idea. They wanted to find more effective ways to help treat age- and -hormone-related changes in the vagina and vulva. The vulva is the outer part of your female sex organs- the clitoris, labia (vaginal lips), the opening to the vagina, and the space between your vaginal opening and your anus, the perineum. The vulva does not include the cervix, womb, or other inside lady parts. Could the same laser-skin-resurfacing technology for women’s faces also help their vaginas? The U.S. Food and Drug Administration (FDA) currently only approved laser therapy aesthetic “skin resurfacing” and not treating the vagina or vulva.
For skin-resurfacing treatments, carbon dioxide (CO2) lasers cause a controlled injury to skin and tissue close to the skin’s surface. Continuous pulses of high-energy light beams vaporize thin outer layers of skin but a shallow enough depth to not cause pain. After the skin is “injured” by the laser, it reheals and develops more flexibility, elasticity, higher moisture levels and can appear more youthful, partially thanks to increased collagen and elastin. Collagen and elastin are two proteins that help give skin and body tissues strength and flexibility. As we age or after an injury (such as childbirth), collagen and elastin levels can change.
Researchers first hypothesized that laser treatment might help vaginal dryness, irritation, and other uncomfortable changes related to aging and atrophy. Atrophy is the change in the lining of the vagina that occurs naturally as estrogen levels fall in menopause. Lower estrogen levels postpartum, especially if you are breastfeeding, can cause similar vaginal and vulvar tissues changes. So those same curious gynecologist researchers began to think that vaginal laser therapy might also help some of the postpartum discomforts women experience after childbirth.
Proponents make the following unscientifically-proven claims that vaginal laser therapy:
- Stimulates new collagen formation
- Causes tissue remodeling
- Restores vaginal flexibility and shape
- Improves vaginal lubrication
- Reduces irritation and pain during intercourse
- Improves the appearance of the external vulvar area
- Treats stress urinary incontinence (leaking urine when you cough, sneeze or jump)
Reportedly these effects are noticeable soon after the first treatment, and improvement continues for several months after completing the entire treatment series (usually 3-4 treatments). Providers of vaginal laser therapy advocate for annual booster treatments because treatment effects may only last 1-2 years.
The FDA Has Not Approved Laser Therapy for The Vagina
It is important to note here that FDA has not approved the use of fractional lasers to treat either vulvar vaginal symptoms of menopause (like atrophy) or postpartum symptoms. Nevertheless, many doctors and health care providers still offer vaginal laser therapy to their patients, even without full approval status.
Why Would Women Consider Shining A Laser on Their Lady Parts?
Vaginal laser therapy does have some selling points when compared with more time-tested treatment options such as pelvic floor physical therapy, vaginal estrogen cream, or even surgery. Pelvic rejuvenation via laser might sound good because:
- There is virtually no downtime or recovery time after the procedure
- You do not need anesthesia and the procedure is relatively pain-free.
- No surgery is necessary, lowering the risk for complications or infections.
- It is a non-hormonal option for women with a history of hormone-sensitive breast cancers who can’t use estrogen-containing treatments.
- May be able to treat urinary incontinence, vaginal dryness, pain with intercourse, pelvic floor relaxation all in one treatment.
- May offer faster and less labor-intensive results than Kegel Exercises or pelvic floor physical therapy
What Happens During Vaginal Laser Treatment?
During vaginal rejuvenation treatment, your doctor inserts a probe similar to a vaginal ultrasound probe into your vagina. Laser beams of different frequencies are directed to the vaginal wall in all directions, causing concentrated thermal heating of the vaginal tissues. During the 3-5minute treatment, women report feeling warmth and heat but no pain.
After vaginal laser treatment, you can return to work and resume your daily life activities immediately. You can begin regular exercise 24 hours after the procedure and have sexual intercourse after 72 hours.
The possible side effects may include vaginal spotting, mild vaginal bleeding, pink or brown vaginal discharge, watery vaginal discharge, irritation, burning when peeing, and discomfort. Side effects should not last longer than four days. Most patients do not experience any lasting side effects.
Laser therapy can also be used extravaginally on the outside of the vagina on the labia (vaginal lips) and vulva. After treatment, vulvar skin may be red, feel sore, itchy, or swollen. It is safe to use cold packs for 20 minutes at a time as needed for swelling and discomfort. Providers recommend waiting one day after treatment to shower or bathe, one week before resuming vaginal sexual activity, and 3-4 days before exercising if you have extravaginal laser therapy.
How Much Does Vaginal Laser Therapy Cost?
Depending on where you go for your treatment and the area you’re looking to get treated, you will pay between $1,000 and $2,500 for vaginal laser therapy. Health insurance does not cover the cost of the treatments.
What Does the Vaginal Laser Therapy Research Show?
Early research studies of laser therapy for vaginal atrophy symptoms in perimenopausal women showed encouraging results. One study of forty perimenopausal women treated with fractional CO2 lasers reported that vaginal symptoms of dryness, itching, and pain with sex improved significantly. In addition, their vaginal tissue cells showed healthier collagen and elastin levels and appeared more similar to younger vaginal tissue. There were no reported bad outcomes or side effects.
Researchers continue to study other ways to use laser therapy for women’s health concerns. These include treating some of the more common concerning symptoms postpartum moms experience: stress urinary incontinence (leaking urine), pelvic floor laxity, and postpartum perineal pain. For example, one study showed a 70% reduction in symptoms in 32 women with “late postpartum pelvic pain” after three laser treatment sessions spaced 4-6 weeks apart. The symptoms which improved after the vaginal laser treatments were pain with intercourse, pain at the vaginal opening, vaginal dryness, itching, and vaginal burning.
What do the FDA and Women’s Health Experts Think?
The problem, from the perspective of the US FDA, the American College of OBGYN’s (ACOG), and the American College of Nurse-Midwives (ACNM), is that we don’t know enough yet about the long-term safety and efficacy of vaginal laser therapy. As a result, on June 30, 2018, the FDA warned against the use of CO2 lasers for “vaginal rejuvenation” or treatment of symptoms of sexual dysfunction.
There are several problems with the research looking at vaginal laser therapy:
- The only available data comes from observational studies and is, therefore, less reliable. There have been no randomized trials or comparative effectiveness published studies looking at the efficacy and safety of vaginal laser therapy for vulvovaginal atrophy, urinary stress incontinence, or postpartum symptoms such as perineal pain.
- Research studies did not consider whether women were using more than one treatment, such as vaginal estrogen cream while receiving vaginal laser therapy.
- The studies also lack long-term follow-up (they only asked women about their symptoms for up to two years after completing treatment). As a result, we don’t know how long the effects of vaginal laser treatments last.
- Providers are concerned that vaginal laser therapy might cause long-term scarring of the vagina or vulva. This could then lead to more pain or injury for future childbirths.
In 2020, the North American Menopause Society (NAMS) reviewed the adverse effects reported in the existing research studies (only 3 studies met study inclusion criteria). NAMS concluded that the FDA’s 2018 safety communication warning was “unsubstantiated and gender-biased.” So, doctors and their patients like yourself may be feeling a bit of whiplash and confusion as to whether vaginal laser therapy is safe or not. More clinical data and time are needed for confirmation of the promise that vaginal laser therapy might offer. Some feminists and women’s health advocates worry that ageism and sexism will drive insecure women to seek expensive and potentially unnecessary laser therapy to attain the “perfect” or “desirable” vagina or vulva.
The Jury is Still Out for Vaginal Laser Therapy
The takeaway is that vaginal laser therapy does not yet have a place in routine gynecological care. As mentioned above, we do not yet know enough about its long-term safety. We also don’t know how long its effects might last. While advertising makes this technology attractive, you might hold off on shining a powerful laser on your most sensitive areas.
Waiting for more information is definitely wise for postpartum women. We don’t know how vaginal or vulvar tissue treated with laser handles a second vaginal delivery. We also don’t know the ideal amount of time to wait before treating with laser therapy after childbirth.
The reality is that many women’s health symptoms are under-reported and untreated. We desperately need better treatments and technologies to improve women’s quality of life. Sexual dysfunction has been shown to cause psychological distress in 43% of women during their lifetime. More than half of women are worried about vaginal laxity, yet 80% of them did not talk about this concern with their doctors. Our desire for safer, more effective treatments tempts us to rush through clinical trials and close study of promising technologies.
ACOG and ACNM both advocate trying clinically proven treatments for painful intercourse, vaginal dryness, leaking urine, or pain. They advise any OBGYNs or midwives to use vaginal laser therapies cautiously and to inform their patients of their “unproven safety record fully.”
It is normal to feel worried, ashamed, or frustrated by your body’s changes postpartum or with age. Don’t forget to seek help and reassurance from your doctor or midwife. They are your best source of accurate medical information. It is their job to tell you all about the safe and effective treatments available to help you feel better. Your doctor or midwife is standing by to help you reclaim your amazing body, all without expensive, fancy laser treatments.