There are times in a woman’s life when dignity becomes an abstract idea. Childbirth is one. A smear test is another.
Then there is the experience of sitting naked from the waist down in a chair resembling something from a dentist’s surgery, while a gynaecologist gets ready to guide a large radiofrequency probe into your vagina.
I was there because, after three children and menopause, things Down There felt slack and floppy. I had also heard that this treatment could work wonders by tightening the internal tissues. Friends had quietly suggested it might make sex more, well, satisfying, too.
More women are now talking about vaginal laxity, the medical term for these changes. That is partly because an expanding industry has emerged around the effects of ageing on vaginal health. The options include creams, lasers, pelvic-floor devices and even home-use gadgets that promise to improve moisture and elasticity.
Yet despite the wave of books, documentaries and television programmes devoted to menopause in recent years, most women still feel far from comfortable discussing what happens to their vaginas as they age.
It may come up during a girls’ night out, but usually only after several drinks—and even then, the conversation is often marked by embarrassment and uncertainty.
At the same time, more women are realising that they do not necessarily have to accept these symptoms. Treatments for vaginal dryness, laxity and discomfort are becoming increasingly popular. Prescriptions for estriol creams, a topical form of HRT designed to restore natural vaginal lubrication, have risen by 400 per cent since 2018, helped considerably by the over-the-counter availability of some formulations.
Vaginal laxity refers to your internal membranes losing their firmness as oestrogen levels fall. It is especially common after childbirth or during menopause
I have been using HRT since the beginning of perimenopause 17 years ago, so fortunately I have not experienced vaginal dryness—and still do not. What interests me, however, are one-off clinical “v-juvenation” treatments that could address vaginal laxity without the inconvenience of a lengthy at-home routine.
Doctors use the term “laxity” to describe the loss of firmness in the internal vaginal tissues after childbirth, or later in life when oestrogen levels decline during menopause. Most clinic-based treatments use high-strength radiofrequency or laser probes to stimulate the body’s repair processes, encourage new collagen and support healthier mucosal tissue. The drawback is the cost: sessions can be about £800 each, and at least three are usually recommended.
Even so, more women are beginning to view these treatments as an investment in their health and wellbeing.
The goal is to tighten and improve the condition of the internal vaginal tissues. This may also help reduce stress incontinence by providing greater support to the base of the bladder and urethra. I have not experienced it myself, but friends say few things are more distressing than constantly worrying about wetting yourself while out and about.
“Women are definitely becoming more aware of these treatments,” says consultant gynaecologist Dr Tania Adib, who specialises in menopause care and vaginal health and is the doctor I chose for my treatment.
Consultant gynaecologist Dr Tania Adib offers a treatment called TL EmFemme 360 to combat vaginal dryness and laxity
“There’s growing acceptance of them, too, although we still have a long way to go. My patients are still nervous about describing their symptoms. They’ll apologise and say, ‘I’m sorry for the detail, but it’s really itchy and burny.’”
The impact can be considerable, particularly on a woman’s sex life. “A lot of women come because they can no longer have comfortable sex,” Dr Adib says.
“When the tissues become extremely dry, you can use as much lubricant as you like and it may still feel like sandpaper. The skin becomes thin and fragile, and can even split.”
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I recognise what vaginal laxity feels like, despite having avoided dryness, and I was keen to discover what Dr Adib’s equipment could do.
Frankly, the treatment—called BTL EmFemme 360—is an extraordinary experience, even by the standards of unusual medical appointments.
The wand delivers radiofrequency energy, heating the vaginal tissues to between 40 and 45 degrees Celsius. This causes the tissues to contract before prompting them to begin the renewal process.
Trying to remain relaxed when someone you’ve only just met is about to slide something that looks like an overgrown hair tong into the most sensitive part of your anatomy is a big ask.
Most of us have had internal medical examinations, or smear tests, and like those, this feels firmly in the realm of a medical treatment, albeit in rather more luxurious surroundings.
I sit there in a throne-like chair, with a strategically placed towel to somehow make me feel a little less exposed.
I feel extraordinarily nervous but the big surprise is that it doesn’t hurt. In fact I can barely feel a thing. Is there something wrong with me? No, Dr Adib assures me, there aren’t actually that many nerve endings in the vagina itself, only in the lower part of it.
Because the RF energy is beaming out in a full 360 degrees circle, it only takes eight minutes and once I’ve got over the weirdness, I feel genuinely quite relaxed.
After the recommended course of three treatments over three months I am amazed by the tightening effect, which I start to notice after my second session.
It genuinely feels as though everything has been gently hoisted back up towards its original position, which certainly makes sex feel better.
You can have sex a few days after each treatment. I didn’t tell my husband what I was having done until after the second session, at which point I could certainly tell the difference. He said he could too.
For women whose main concern is vaginal dryness, Dr Adib believes the first step should be hormone treatment.
‘Women need to know there is usually a solution,’ she says. ‘It’s about choosing the right combination for the individual.’
Personally I’m happy with my big bang – no pun intended – approach where you get results in just a handful of high-powered sessions. As a means of revving up enjoyment of sex, and helping your internal membranes stay healthy and lubricated for longer, it’s worth the embarrassment.
Joely Hargan is a pseudonym.
Dr Tanya Adib – www.adib.org.uk
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