The Journal of the American Medical Association published an editorial in 2021 in which ob-gyns argued for the cessation of these devices. “These results suggest that use of vaginal laser technology for the management of genitourinary symptoms should be limited to a research setting until high-quality evidence supports both effectiveness and safety,” they wrote.
But the strong words from organizations like the FDA and ACOG have not dimmed the appeal, or the big business, of these treatments. You can still walk into med-spas and doctors’ offices (including gynecologists, but also dermatologists and plastic surgeons) across the country to get your vagina “rejuvenated.” “There is money to be made by doing it,” says Howard Sharp, MD, the chief of general obstetrics and gynecology at the University of Utah and head of their Pelvic Pain Clinic.
That can leave patients confused. “It’s a buyer-beware market,” says Mary Jane Minkin, MD, a gynecologist, clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine, and co-director of the Sexuality, Intimacy and Menopause clinic for cancer survivors at the Smilow Cancer Hospital at Yale New Haven Health.
So, how did vaginal rejuvenation devices become available in the first place?
Let’s back up for a second. The answer to this question has nothing to do with multiple orgasms, and everything to do with tattoos and crows-feet. The specific kinds of lasers (carbon dioxide, or CO2, and erbium-YAG) and radio-frequency wands being promoted as vaginal wonders were first cleared by the FDA for reversing skin issues, like regrettable ink, wrinkles, and acne scars. Soon they were FDA-cleared for use further south, too. Not for orgasm improvement, though: “For removing HPV warts and precancerous lesions,” says Cheryl Iglesia, MD, FACOG, FPMRS, an obstetrician-gynecologist and female pelvic floor reconstructive surgeon, a professor of obstetrics, gynecology, and urology at Georgetown University School of Medicine, director of the Section of Female Pelvic Medicine and Reconstructive Surgery at MedStar Washington Hospital Center, director of the National Center for Advanced Pelvic Surgery at MedStar Health, and a leading researcher on energy-based devices. “The problem is now they’re being promoted for indications they’re not cleared for—the claims that fall under ‘vaginal rejuvenation.’”
The FDA statement from 2018 “emphasized that, although the FDA is aware that devices such as lasers are used for a variety of surgical applications, the agency has not approved their use for any specific [“vaginal rejuvenation”] indication,” says JoAnn Pinkerton, MD, an obstetrician and gynecologist, a professor of obstetrics at the University of Virginia, and the executive director of the North American Menopause Society. Quite the contrary, the FDA stated, so-called vaginal rejuvenation “procedures use lasers and other energy-based devices to destroy or reshape vaginal tissue. These products have serious risks and don’t have adequate evidence to support their use for these purposes. We are deeply concerned women are being harmed.”
What are the risks of vaginal rejuvenation devices?
Theoretically, lasers “rejuvenate” vaginas much the same way that they make skin look younger: By poking teeny holes in the tissue of the vagina and vulva, they’re supposed to stimulate the tissue’s natural wound-healing process. Radio-frequency devices use heat on deeper tissue to activate fibroblasts. In both cases, collagen production and blood flow to the area increase, making vaginal walls plumper and better lubricated, respectively. “But the lasers work by targeting water in tissue,” says Dr. Iglesia. “If you use one to treat vaginal dryness and there’s no water to target, that could cause a burn.”
