As a medical professional, I navigate two distinct realms. My primary training is in obstetrics and gynecology, and I work part-time with the NHS. Additionally, I have a specialization in advanced aesthetics, with a focus on cosmetic gynecology. This involves addressing both the functional and aesthetic aspects of the intimate area, including skin texture, volume, and pelvic floor rejuvenation.

Lately, I’ve noticed a new trend among my patients. While the term ‘Ozempic face’—a gaunt, aged appearance resulting from rapid weight loss due to GLP-1 medications—is widely discussed, there’s another related issue that’s gaining attention. I refer to this as ‘Ozempic vagina’.

This condition might not be something many consider, yet it’s important to recognize that any drug inducing quick weight loss can affect the intimate area, often in unforeseen ways.

Much like the facial sagging and laxity associated with these drugs, similar effects can occur in the intimate area. However, these changes are not as visible as those on the face. Increasingly, women, especially those who are perimenopausal or menopausal, are thrilled with their weight loss results but find themselves grappling with an intimate area that appears older, feels uncomfortable, and functions differently.

Here are the main challenges my patients are encountering, along with potential treatments…

Lax labia

Just like the loss of facial volume, rapid weight loss can lead to a decrease in volume in the intimate area. Many patients report that their labia appear saggy, particularly when standing.

From an aesthetic perspective, the area no longer looks youthful and this can have a knock-on effect on their self-esteem and, subsequently, their relationships.

Crucial cushioning

Beyond aesthetics, the loss of fat has serious physical implications. We naturally have a layer of fat across the pubic bone (the mons pubis) and the outer lips (labia majora) and that cushion has a functional role to play.

Dr Sima, who specialises in gynaecology, says the sagging and laxity seen on a face when a patient starts taking weight loss drugs is often reflected in the intimate area too

When patients lose that padding they can find that wearing underwear or tight clothes becomes painful because there is no support for the inner lips. The increased friction can also lead to pigmentation issues but, more worryingly, this anatomical change affects your health. Increased friction can result in higher susceptibility to thrush and bacterial vaginosis, and as the labia lose volume, the urethra becomes less protected, increasing the risk of urinary tract infections (UTIs).

If the women are already menopausal or perimenopausal, a time at which the tissues in this area already have a tendency towards atrophy, then weight loss just compounds the problem.

Hormonal horrors

Even if GLP-1 users aren’t menopausal or perimenopausal they may still find that taking these types of drugs has an impact on their hormone levels. Adipose tissue (body fat) actually plays a role in producing oestrogen, meaning higher body fat usually correlates with higher oestrogen levels.

When a patient takes a drug like Ozempic (Wegovy in the UK) or Mounjaro, they experience a rapid decline in body fat, which can lead to a rapid decline in oestrogen levels. This effectively mimics – or exacerbates – perimenopausal symptoms which can include vaginal dryness, decreased lubrication and a lower libido.

Dehydrated down there

Weight-loss drugs don’t only reduce appetite, they can also reduce thirst, often leading to general dehydration. If you are dehydrated systemically, you will experience intimate dryness. This combination of low oestrogen and dehydration can make intercourse painful and diminish sensation.

THE SOLUTION

Before I treat any patient it’s imperative that I understand what is causing the problem – you can’t just treat the symptom without understanding the root cause. 

Although the use of GLP-1s has become more commonplace, it’s still not something that a patient will automatically reveal, so we’ll do a very in-depth consultation before discussing what their major concerns are.

At Dr Sima’s clinic, she uses a range of treatments to combat symptoms of ‘Ozempic vagina’, such as micro-needling to replace lost volume and hyaluronic acid injections to reduce dryness

Sometimes, I’ll use a treatment that will improve the quality of the skin and give a lifting effect. You may have heard of the Morpheus 8, which is a radio frequency micro-needling treatment that is used on the face. The Morpheus 8 V is similar but designed for the intimate area. For more significant changes, we might use non-surgical labiaplasty (from £3000) which uses radiofrequency at higher temperatures to tighten the area and improve aesthetic appearance.

Once we have improved the skin quality with treatments like micro-needling, we can look at replacing that lost volume. We can use fillers (around £300-£500) to restore the ‘cushion’ in the outer lips, which provides the necessary support and protection for the inner structures. We might also focus on pelvic floor strengthening to improve overall support.

And to combat dryness and laxity, I often combine treatments. So maybe using hyaluronic acid injections to deeply hydrate the tissues alongside internal radiofrequency treatments to rejuvenate the area, improve blood flow, and help with dryness and sensation.

There is no quick fix. My approach is holistic and customised to each patient’s specific complaints. It usually takes three to six months to achieve the desired results and most of my patients will come back in for an annual maintenance treatment. Just like losing weight, it’s not a one-and-done thing.

drsima.co.uk