Q: What are the pros and cons of Votiva?

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.

Question 1

What is Votiva?

Accepted Answer

Votiva is a nonsurgical vaginal rejuvenation treatment that can help reverse functional and aesthetic changes from childbirth, aging, and menopause.

Approved by the U.S. Food and Drug Administration (FDA) for tightening pelvic floor muscles and rejuvenating skin elasticity, the device uses radiofrequency energy to stimulate the tissue’s natural healing response and new cell regeneration. This renews the vaginal tissue’s structural collagen and elastin fibers, leading to tighter tissue and increased blood flow.

While this vaginal tightening procedure won’t yield the same results as plastic surgery procedures like vaginoplasty or perineoplasty, Votiva treatment can improve a range of feminine health concerns, including vaginal laxity, atrophy, dryness, reduced sensation, painful sex, and urinary incontinence.

Question 2

What are the pros and cons of Votiva?

Accepted Answer

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.

Question 3

How much does Votiva cost?

Accepted Answer

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.

Question 4

Votiva before and after pictures

Accepted Answer

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

Question 5

How does Votiva work?

Accepted Answer

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.

Question 6

What happens during a Votiva treatment?

Accepted Answer

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.

Question 7

What is the recovery time for Votiva?

Accepted Answer

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.

Question 8

How soon will you notice Votiva results?

Accepted Answer

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.

Question 9

Does Votiva make the vagina tighter?

Accepted Answer

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.

Question 10

How long does Votiva treatment last?

Accepted Answer

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.”

Question 11

Is Votiva safe?

Accepted Answer

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.

Question 12

What are the alternatives to Votiva?

Accepted Answer

Providers offer several nonsurgical vaginal rejuvenation options that you may consider alongside Votiva.

ThermiVa also uses radiofrequency energy to regenerate vaginal tissue. With one wand for both internal and external tissue, ThermiVa focuses on below-the-surface collagen and elastin remodeling.
MonaLisa Touch is a fractional CO2 laser that makes controlled micro injuries in both the internal vaginal canal skin and outer vulva skin to stimulate cell regeneration. You need to abstain from sex longer than you would with a radiofrequency treatment, but otherwise normal activities can be resumed immediately.
The O-Shot injects platelet-rich plasma (PRP) from your own blood into the vaginal walls and clitoris via injection. Growth factors in the PRP jump-start cellular repair to improve blood flow and cell functioning, which can increase sensation.

VOTIVA

Kali Swenson

Kali Swenson

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	Votiva nonsurgical	ThermiVa nonsurgical	MonaLisa Touch nonsurgical	O-Shot nonsurgical
Worth It Rating	86%	100%	100%	81%
Average Cost	$2565	$2290	$1950	$1445
Downtime	No downtime	No downtime	Minimal downtime	No downtime
Anesthesia	General anesthesia	Topical or no anesthesia	No anesthesia (possibly numbing cream)	Topical and local anesthesia

Kali Swenson

Kali Swenson

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