Countless treatments promise rejuvenation for various aspects of life, from fitness routines to intimate experiences. However, the belief that vaginas and vulvas also require similar rejuvenation procedures is a widespread misconception that needs to be addressed.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is shedding light on this topic and warning against surgical or laser procedures that lack sufficient clinical evidence.

Understanding Vaginal Rejuvenation

Vaginal rejuvenation, as it is commonly referred to, encompasses various techniques such as “vaginal rejuvenation,” “revirgination,” “designer vaginoplasty,” and “G-spot amplification.”

These procedures are relatively new and poorly understood, lacking substantial clinical evidence to support their efficacy. Renowned medical organisations like the American College of Obstetricians and Gynaecologists (ACOG) and the Society of Obstetricians and Gynaecologists of Canada discourage cosmetic procedures for female genitalia that are not medically necessary. RANZCOG (Australia) reinforces the importance of distinguishing between elective cosmetic procedures and medically indicated reconstructions, which address conditions like genital prolapse, reconstructive surgery after female genital mutilation, and labiaplasties for medical indications.

The Controversy Surrounding Vaginal Rejuvenation Techniques

The term “vaginal rejuvenation” primarily refers to treatments using devices that deliver thermal energy to the vaginal mucosa, with marketing claims targeting the treatment of vaginal menopausal symptoms, sexual dysfunction, and urinary incontinence. However, these treatments, including CO2 and Erbium lasers, and radiofrequency ablation, lack approval from the (US) Food and Drug Administration (FDA) for these specific indications. In addition, they are not supported by Medicare reimbursement, raising concerns about their safety and efficacy.

In Australia, only the Erbium laser has obtained approval from the Therapeutic Goods Administration (TGA) for treating vaginal atrophy. However, it is essential to understand that even with TGA approval, the efficacy and safety profiles of these treatments remain subjects of ongoing investigation. Consequently, RANZCOG advises caution and supervision when considering vaginal laser treatments. The College emphasises the importance of conducting such procedures under the guidance of local ethics committees until more comprehensive evidence is available, comparing these treatments against standard therapies.

Role of Obstetricians and Gynaecologists

Amidst the confusion surrounding vaginal rejuvenation, obstetricians and gynaecologists play a pivotal role in educating women about the natural variations in the appearance of normal female external genitalia. They emphasise that each woman’s anatomy is unique and undergoes normal physiological changes over time, particularly following childbirth and menopause. It is essential for women to embrace their natural beauty and understand that there is no single standard for genital appearance.

Thorough Assessment and Sexual Counselling

For individuals seeking procedures unrelated to gynaecological conditions, a thorough assessment is crucial. Medical professionals should carefully evaluate the reasons behind such requests and engage in open conversations with patients to understand their motivations fully. For patients seeking surgery for the purpose of enhancing sexual gratification, sexual counselling is recommended. RANZCOG is deeply concerned that some procedures may exploit vulnerable women and strongly advises against promoting or advertising such surgeries as a means to enhance sexual function.

Clinical Evidence and Informed Decisions

RANZCOG strongly discourages the performance of any surgical or laser procedure that lacks current peer-reviewed scientific evidence, except when conducted within appropriately constructed clinical trials. To ensure transparency and ethical decision-making, the College also cautions against accepting financial incentives, such as flights and accommodation, from manufacturers of commercial products to attend information sessions. Such sponsorships may raise concerns about potential conflicts of interest and may not align with local hospital protocols.

At present, there is no scientific evidence to support the notion that these procedures effectively enhance sexual function or improve self-image. Women considering such treatments should be aware of potential risks, including scarring, adhesions, permanent disfigurement, infection, dyspareunia, and altered sexual sensations.

Engaging in open discussions about these potential risks with a medical professional is vital before deciding to undergo any such procedure. Ultimately, the focus should be on embracing the natural diversity and beauty of the female anatomy and prioritising health and wellbeing over societal pressures and cosmetic ideals.