Vaginal laser surgery? Just say no!

By: Cindy Pearson and Abby Miller

In late June 2018, the U.S. Food and Drug Administration (FDA) warned against using lasers (“energy-based” devices) for vaginal “rejuvenation” or vaginal cosmetic procedures. According to the FDA, using lasers in this way can lead to vaginal burns, scarring, pain during intercourse and chronic pain. These devices have been approved by the agency for specific gynecologic uses like the destruction of precancerous cervical or vaginal tissue and the removal of genital warts, but not for other uses.

Scott Gottlieb, commissioner of the FDA, explained that many manufacturers are marketing their devices for uses not approved by the FDA. Gottlieb said these unapproved uses for procedures like vaginal “rejuvenation” have caused numerous cases of serious harm and referred to the deceptive marketing as “egregious,” while also stating the procedure is not only dangerous, but has no proven benefit. The FDA identified Alma Lasers, BTL Aesthetics, BTL Industries, InMode, Cynosure, ThermiGen and Sciton as manufacturers inappropriately marketing lasers for vaginal “rejuvenation” and other unapproved uses.

In addition to “rejuvenation”, which is a cosmetic procedure, the FDA also criticized manufacturers for marketing lasers to treat symptoms such as vaginal dryness or itching, pain during intercourse, decreased sexual sensation or vaginal “laxity”.  No manufacturer has submitted evidence to the FDA demonstrating that lasers are effective for any of those symptoms.

Why did the FDA take the unusual step of issuing a warning to the general public about the mis-use of a surgical device?  We don’t know all the reasons the FDA acted, but we do know that the number of women getting cosmetic surgery on the vagina and vulva has surged over the past few years. According to the American Society of Plastic Surgeons , over 12,000 procedures were performed by their members in 2016. This is a 39% increase over the span of just one year!  (These numbers do not include gender-affirming surgery, which is a treatment, not a cosmetic procedure.)

What is vaginal “rejuvenation”? It is a marketing term. There’s no such thing as rejuvenating a vagina, through surgery or any other method.  However, vaginal “rejuvenation” is being promoted, including by surgeons. They offer surgery to restore or enhance the vagina’s appearance, which can include narrowing the opening of the vagina.  “Rejuvenation” surgery sometimes also changes the appearance of the inner and outer lips of the vulva (the labia).  Why have these procedures become so much more common?  We don’t know for sure, but it seems likely that it’s a combination of push and pull – women being pulled into cosmetic surgeons’ offices by aggressive ads and messages designed to provoke insecurity, and women being pushed, or self-propelled, by their own intrinsic feelings about their genitals. The pervasive nature of online pornography may be a factor in creating a feeling of dissatisfaction with a normal body, but even without being exposed to unrealistic images of women’s genitals, some women may feel bad about how they look.  Shame about our genitals is still too common.

These influences lead women to seek out medical solutions, despite the fact that there is no solid evidence that the majority of people who go through vaginal cosmetic surgery are satisfied with the result.

What to do? If anyone comes near your vagina with a laser, just say no!  If you have troubling symptoms, including the ones described by the FDA, search out proven remedies – lubricants help vaginal dryness, Kegel exercises help vaginal tone and incontinence, etc.  Check out Our Bodies, Ourselves, the Beautiful Cervix Project and material produced by the Feminist Women’s Health Centers for depictions of real women and their genitals.

You can learn more about what it means to be genitally feminist and healthy in this article by the NWHN.