Votiva: What You Need to Know

Pros

• Votiva treatments are a nonsurgical way to address several symptoms in the vaginal area at once.
• Your provider can customize your treatment plan to target your specific concerns, whether you mainly want to address vaginal dryness, improve other symptoms of sexual dysfunction, or change the appearance of the labia by stimulating collagen production and boosting elasticity.
• Votiva treatments are generally safe, with little reported risk of adverse side effects.
• A majority of RealSelf members say Votiva was “Worth It,” with many reporting a more satisfying sex life and remarkable improvements in stress urinary incontinence.
• There’s no downtime following the Votiva procedure, aside from waiting three days to have sex.

Cons

• You won’t see or feel significant results immediately. They develop over a few months as your cells respond to the treatment.
• Your body continues to age and change after Votiva treatment, so the results aren’t permanent and don’t fix vaginal atrophy for good. 
• You’ll need three treatment sessions, spaced one month apart, to see initial results from Votiva vaginal rejuvenation. 
• Annual follow-ups are also recommended to maintain results.
• This nonsurgical treatment staves off the need for plastic surgery, rather than replacing it. Your vaginal tightening results won’t be equivalent to those from a vaginoplasty.

• Average Cost:
• $2,725

• Range:
• $1,500 - $5,000

Votiva costs typically include a package of three treatment sessions. Buying a series of treatments up-front tends to be more cost-effective than purchasing them individually, since most providers offer package discounts. 

This is an elective procedure and not considered medically necessary, so insurance doesn’t cover it.

The Votiva photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

The Votiva system delivers radiofrequency energy below the skin’s surface, in the form of heat, to remodel existing collagen and stimulate even more collagen production. 

The heat creates controlled microdamage that triggers your body’s natural healing process, prompting faster cell turnover and more blood flow to the vaginal area. 

This tightens tissues and restores nerve signaling for improved sensation and lubrication, making it a worthy option for whose who struggle with symptoms of sexual dysfunction due to menopause.

A 2019 study in the Plastic and Reconstructive Surgery–Global Open journal also found that Votiva treatments improved maximal pelvic floor contraction.

RealSelf Tip: Doctors on RealSelf recommend waiting at least six months after vaginal childbirth before pursuing a treatment like Votiva, to give your pelvic floor time to heal and adjust.

Doctors recommend an initial series of three, 30-minute treatment sessions, spaced one month apart, for best results.

Here’s what to expect during your session:

• First, your provider may apply a numbing cream to the external tissue, to help make the sensation of the heat more tolerable.
• Once you’re numb, they will treat the inside of your vagina and the external tissues of your vulva with various handpieces, to address your specific concerns.
• The FormaV handpiece looks like a wand and is used primarily in the vaginal canal, where it can treat the pelvic floor muscles. 
• The Aviva handpiece treats the vulva (including the labia minora, labia majora, and clitoral hood) to restore function and appearance. The manufacturer of Votiva, InMode, markets Aviva as a nonsurgical alternative to labiaplasty (sometimes marketed as a “scarless labiaplasty”). While surgical labiaplasty removes excess tissue, Aviva contracts and rejuvenates the tissue.
• The Morpheus8 handpiece combines RF energy with microneedling to deliver heat below the skin’s surface for both subdermal tissue remodeling and epidermal resurfacing.
• The FractoraV wand was previously used with the Votiva machine, and some providers’ offices may still use it. It uses very tiny pins to apply energy to the external skin for resurfacing.

During your treatment, you may feel some pressure on your bladder, mild cramping, or heat. The intensity of the treatment is adjustable, so let your provider know if it feels too uncomfortable.

Given the intimacy of the procedure, it’s important to find a provider who makes you feel very comfortable.

You can resume most daily activities immediately after your Votiva treatment, but you may experience some soreness and slight discomfort for a few days.

You’ll also need to abstain from sexual intercourse for three days, to allow your tissues to heal.

Many women notice a difference—particularly a decrease in stress urinary incontinence—after the first treatment. 

More significant changes come as cells turn over and new collagen is produced, so results continue to improve gradually over a few months, even after your third treatment.

Vaginal tightening is one of the many benefits of the Votiva procedure. It also treats the vulva by stimulating collagen production, so you can also anticipate tighter skin and greater elasticity in the full vaginal area.

Again, it’s not a substitute for a surgical tightening procedure like vaginoplasty, so it may not be the best option for people with significant vaginal laxity. But it can create a noticeable improvement.

Votiva results last “anywhere between 8 months and 3 years and definitely work to stave off the need for surgery,” says Dr. Jennifer R. Berman, a physician in Los Angeles who specializes in sexual health. “Maintenance treatments are typically desired every 9–12 months after that.”

Votiva is considered a safe treatment, with minimal reported risks and side effects. 

“While there are potential minor side effects (such as change of pigmentation and excess redness), none have been experienced by patients treated in our office,” notes Dr. Wesley Anne Brady, an OB-GYN in Dallas, Texas. 

Votiva treatment involves heat, but “the temperature reached is no higher than 43 degrees celsius (109 Fahrenheit) … [which is] not hot enough to harm anything,” adds Dr. Marco A. Pelosi, an OB-GYN in Bayonne, New Jersey.

To maximize safety and reduce the likelihood of Votiva risks and side effects, be sure to do your research and find a reputable provider, such as a board-certified OB-GYN or plastic surgeon who is well-reviewed and experienced in offering Votiva vaginal rejuvenation treatments.