Vaginal Laxity

Vaginal laxity is when your vaginal tissues lose tightness or feel loose. It most commonly happens after pregnancy and childbirth, as well as with aging or menopause. Vaginal looseness may cause a decrease in sexual satisfaction or negatively impact your body image.

Treatment isn’t always necessary. But there are some options for a loose vagina — sometimes grouped under the term vaginal rejuvenation. The most effective option is usually pelvic floor physical therapy. Surgery is generally not recommended unless you have pelvic organ prolapse.

Symptoms of vaginal laxity

The main symptom is vaginal looseness. You may feel like your vagina is sagging. Other common symptoms are:

• Loss of tightness (you may feel this more when something is inside your vagina)
• Decrease self-esteem
• Loss of libido
• Loss of sexual pleasure (or being unable to orgasm)
• Trapping of labia in your underwear or your labia rubbing on clothing

Laxity isn’t the same as pelvic organ prolapse (POP). Though it may feel like it, nothing is falling out of your vagina. With POP, there’s usually a visible bulge from a pelvic organ sagging through your vagina. If you have symptoms of POP or other symptoms, such as leaking pee or pain during sex, you should consult your healthcare provider.

Over time, a loose vagina can lead to loss of intimacy with your sexual partner(s). It can take a toll on your confidence and make you not want to have sex. This could impact your quality of life.

Vaginal laxity causes

Your vagina is made up of tissue. The tissue is typically tight, but flexible. But certain factors can cause it to stretch and not go back to its same level of tightness.

Some of those factors are:

• Pregnancy
• Vaginal childbirth
• Aging
• Menopause
• Pelvic surgeries

How doctors diagnose it

Your healthcare provider can ask you about your symptoms and how they affect your life. Vaginal laxity is unique and personal. Tell your provider how you feel and how your life is impacted.

Your provider will examine your vagina. They may insert a gloved finger inside. They’ll look and feel for signs of looseness, like:

• Loss of firmness in your vaginal walls
• Changes in the vaginal tissue
• Weak vaginal muscles
• Elongated labia (vaginal lips)

How is it treated?

The goal of treatment is to improve the tightness of your vagina and reduce your symptoms.

The best treatment is usually pelvic floor physical therapy. This involves working with a physical therapist on pelvic floor exercises, like Kegels. It can help improve your strength and teach you how to better support your vaginal muscles.

Nonsurgical treatments using energy or lasers aren’t effective for tightening the muscles of your vagina. These are also expensive treatment options. Keep in mind, long-term studies on these methods are limited. The following therapies may be suggested to you by a provider:

• CO2 laser: The laser heats the upper layers of the tissue in your vagina. This can cause the lower tissue to make more collagen. Collagen can help improve firmness. This is typically used for menopausal symptoms due to the loss of estrogen or lichen sclerosus.
• Radiofrequency (RF) therapy: RF waves heat your vaginal tissue to promote blood flow and collagen production. This isn’t a proven therapy and is unlikely to help your symptoms.

Surgery (vaginoplasty) isn’t recommended for this condition as it can lead to pain during sex. A labioplasty may help if you have elongated vaginal lips. This is a common and effective procedure.

Your provider may also discuss other factors that affect vaginal support. This includes things like heavy lifting, chronic coughing or hormonal changes during menopause. They may recommend ways to treat or improve these factors, too. For example, if menopause could be a factor, estrogen creams or sexual lubricants could be part of your treatment plan.

What can I expect if I have vaginal laxity?

Vaginal laxity is common, especially if you’ve had children. Many women notice changes in the tightness of their vaginas. It’s nothing to feel embarrassed about. A healthcare provider can help you understand your options and decide what treatments may be able to help you. You may have to try one or several options to feel relief. But relief is possible.

What is the difference between prolapse and laxity?

A prolapse is when one of your pelvic organs sags or drops outside of your vagina. Laxity is a sensation or feeling of looseness.