Last week I found myself discussing labia with a beauty PR in Mayfair over lunch – a topic I don’t normally get close to. But “vaginal health and wellness” is such a hot topic among over-40s that I bet you’ll soon be doing the same thing I am.
Blame it on menopausal women who no longer suffer in silence and find ways to compensate for the many debilitating consequences of their stage of life.
Or point out the dawning realization that non-surgical “tweaks” designed to combat collagen loss in the face can translate quite seamlessly to your nether regions. Either way, the truth is out there – and the ‘down below’ makeover is just around the corner.
A degree of urinary incontinence, lack of lubrication, burning sensation, itching and even discomfort while sitting can all be part of life as we age and/or go through menopause.
The reality is that age and menopause cause a loss of hydrating, plumping and supportive collagen in the vulvo-vaginal area, and this leads to more problems than your mother ever told you about. A degree of urinary incontinence, lack of lubrication, burning sensation, itching, and even discomfort when sitting (due to, wait for it, atrophy of the labia) can all, to a greater or lesser extent, become part of life.
Having children, meanwhile, can damage the bladder nerves, pelvic muscles, and supporting vaginal tissue, leading to even more bladder leaks.
And the good news? You no longer have to tolerate it ‘because it’s natural’.
“My patients want to take control of their bodies,” says Galyna Selezneva (at drritarakus.co.uk), an aesthetic doctor with a background in gynecology who has become the favorite ‘vagina whisperer’ for London’s wealthy.
She has noticed that women tend to reinvent themselves after childbirth or when they enter menopause, divorce, the death of a partner, an empty nest – “milestones that change lives, but not the end.” need to be part of life as you know it’.
Selezneva, whose vaginal tweakment clientele breaks down as “60 percent between the ages of 50 and 60, 20 percent over 70, and the remaining 20 percent around forty,” estimates that her bookings have increased in the past two years “by about two-thirds ‘.
She says women now bring up the subject for no reason, talking about function and strength rather than aesthetics, which used to be the main driver for “downstairs” procedures.
Her sentiments are echoed by consultant gynecologist Ms Tania Adib (adib.org.uk).
“I have noticed a significant increase in women seeking vaginal lasers, injectables and other regenerative treatments,” she says. “They do it for themselves: they want to feel good and look good, but also enjoy the benefits of feeling better that often comes with it.”
The menu of options is mind-boggling and also sounds terrifying. As with facial adjustments, most procedures are based on stimulating cell regeneration through heat or by injecting substances.
Unsurprisingly, in some cases local anesthesia is required to get through the procedure, although none require recovery time. Needless to say, you want to look for a highly experienced doctor who is well-versed in gynecology.
As for your modesty, try to forget it altogether. I suggest that you check in advance your doctor’s bedside manner: you want it to be excellent.
These are the five most popular and effective V tweaks.
Inge van Lotringen reveals the most popular and effective vagina adjustments available
For a tighter vagina, simply sit back and relax
Emsella high-intensity electromagnetic muscle stimulation (Dr. Selezneva at Rita Rakus Clinic, Knightsbridge, drritarakus.co.uk)
What is it? Kegel exercises are the gold standard for strengthening the pelvic floor muscles that no longer effectively control the urge to urinate, and this machine, which is essentially a chair, delivers the equivalent of 11,000 muscle contractions in half an hour. Best? You just sit on it, fully clothed.
What is happening? The intense, bizarre, but not painful energy just travels in waves through your vajayjay as you read a magazine.
Results and costs? Because there are several reasons for a leaky bladder, Adib recommends an internal examination to determine if poor muscle tone is your problem before opting for this treatment. If so, four to six sessions, a few days apart, will make a significant difference in the leakage caused by coughing, laughing or simply knowing there is a toilet nearby. Single sessions cost around £200, while Emsella treatment packages for six sessions can cost £850 to as much as £2,000.
For fuller female bits and bladder control
Emfemme 360 radiofrequency vaginal remodeling (Dr. Selezneva at the Rita Rakus clinic)
What is it? Radiofrequency heat at a relatively comfortable 42 degrees Celsius gently increases collagen production, including in and around the vagina and vulva.
This improves the “cuddliness and plumpness” of the labia, as Selezneva memorably puts it. “It also increases internal lubrication and can soothe the itching and burning that can occur when tissues go somewhere,” she says.
Importantly, the ‘collagen remodeling’ strengthens the vaginal walls and their ability to support the bladder, while the heat soothes an overactive bladder, helping to control incontinence.
What is happening? The recently launched Emfemme 360 and its previous incarnation, the UltraFemme, treat the vagina in eight minutes and the vulva in about twelve minutes.
The heat is mild and Dr. Selezneva explains that ‘the vaginal skin has no pain nerve endings. Underlying structures such as muscles and fascia [thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place] do have a pain response, just like the uterus.’
But there’s no getting around the fact that the ‘treatment head’ is actually a heated, er, ‘wand’ (available in two sizes) that is moved in and out as you sit back and think about England.
Results and costs? Three sessions are recommended. Some may notice increased lubrication after a single treatment, but fuller tissues and greater comfort and bladder control will occur approximately three months after your last session. Costs start at £350 for single in-house sessions, but Selezneva charges £3,200 for a full course combining in-house and external treatment.
For tissue regeneration and lubrication
Fractional vaginal laser (Tania Adib at The Medical Chambers, Kensington, adib.org.uk)
What is it? A vaginal laser causes tiny micro-tears to trigger a healing ‘collagen remodeling response’ in the vagina and at the entrance, thickening and tightening the tissues for comfort and bladder support. The procedure is particularly “great for identifying dryness,” says Adib, who uses the “best-researched fractional carbon dioxide laser” for this purpose, the MonaLisa Touch.
What is happening? Your doctor will insert a small probe to deliver the laser energy; it only takes five minutes.
It is painless due to the absence of vaginal pain fibers, but ‘the vulvo-vaginal entrance is often where the biggest dryness problem is and it is one of the most sensitive parts of the body, so I will apply a numbing cream there before the treatment ‘, says Adib.
There is a small risk of burns and loss of sensation (choose a highly experienced specialist) and you may experience mild irritation for a day or so after the procedure.
Results and costs? Initially you will need three treatments, followed by maintenance treatments approximately once a year. Ninety percent of patients achieve good results after three sessions; some notice improvement after just one. Adib charges £1,800 for the course and £650 for a single session.
For stimulating collagen and orgasms
Intimate PRP (Tania Adib at The Medical Chambers)
What is it? Platelet-rich plasma therapy, or PRP, involves placing a small amount of your blood in a centrifuge for a few minutes to separate the plasma, which is rich in regenerative growth factors.
These can be injected into the vagina to “enlarge and strengthen the collagen around the urethra to keep them strong, and into the vulva to help regenerate dry, stiff tissues,” says Adib.
And there is another application: ‘PRP injections in the clitoral hood strengthen the tissue, improving the intensity of the orgasm.’ Who knows?
What is happening? A numbing cream is applied before the injections, supplemented with a pain-relieving injection if you are having your clitoris treated. Thank God. After the treatment, temporary spots and bruises may occur. The entire procedure takes about an hour.
Results and costs? Adib charges from £1,150 for the procedure and follow-up. You will notice the full results after three months, and this usually lasts a year.
For cushioning of labia, tightness and moisture
Vulva fillers and boosters (Sarah Tonks at The Lovely Clinic, Chelsea, thelovelyclinic.nl)
What is it? Desirial Plus is a different kind of ‘lip filler’: a dense hyaluronic acid gel, specially designed to re-cushion the outer labia, which can lose density and tone as collagen is lost. Padding the outer labia also works to provide protection for the labia minora if they are exposed and causing discomfort.
“It works wonderfully, but you need quite a bit of product,” says cosmetic doctor Dr. Sarah Tonks, who also uses sister product Desirial, an injectable hydrator. Injected at the mouth of the vagina it spreads to restore moisture, tone and tightness.
What is happening? ‘To inject the inside and mouth of the vagina, use a tampon with anesthetic gel an hour in advance, so that you do not feel the injection,’ says Tops. ‘The worst are the numbing injections for the outer labia, after that it’s easy.’
Some bruising is possible, as well as a very small risk of lumps and encapsulation, so these treatments should only be entrusted to highly qualified doctors.
Results and costs: Desirial Plus filler can last a few years, while Desirial hydrating injections last six to nine months. Desirial starts at £500; for Desirial Plus, two syringes cost £1,445.