Will a labiaplasty help minimize pain during intercourse? What options do I have? 50 y/o

Question

As a 50 year old woman still having pain when having sex is depressing,Is Labiaplasty surgery a corrective surgery that can help me ?

Gary J. Alter, MD · Answer

A labiaplasty can certainly decrease pain with intercourse if that is area causing the pain, and a clitoral hood reduction can reduce your size. However, it must be performed by a surgeon with experience. One of the two most common labiaplasty techniques is the central wedge technique, which I invented in 1995 and published in the plastic surgery textbooks. It is also known as the "V" or wedge technique. Gynecologists and most plastic surgeons perform a labioplasty very differently. They essentially trim the labia minora (inner vaginal lips) and leave a long suture line instead of the normal labial edge. Their technique is the same whether a scalpel or a laser is used. This often causes asymmetry, scallops, and a wide suture line, and a higher incidence of long-lasting pain. In contrast, the central wedge removes triangles of tissue and bring the normal edges together. Thus, the normal labial edges, normal color, and normal anatomy are preserved, but the darkest labial tissue is usually removed. If you have extra tissue on your clitoral hood, it can be reduced at the same time. Your clitoral hood is thick, wide, and protuberant. It can be decreased somewhat by reducing the sides. I pioneered a clitoropexy with clitoral hood reduction in which the clitoris is pushed closer to the pubic bone and the width, thickness, length, and protuberance of the clitoral hood can be drastically decreased. I have done it over 350 times with excellent results. I have not published this technique, so no one does it like me. No matter the technique, an inexperienced or unskilled surgeon can lead to a high rate of complications, chronic scar discomfort, labial deformities, and further surgery. About 40% of my labia cases are reconstructions of other surgeons' labiaplasties.

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY

Gary J. Alter, M.D.
Beverly Hills, CA - Manhattan, NY

Richard Bloy, MD, FACOG · Answer

Redundant labia can cause some irritation, but not pain. There are several reasons for pain, and they should be explored. The most likely reason for pain at 50 years old is low estrogen and testosterone.

Burcak Tok, MD · Answer

hello , It is necessary to look at why there is pain during sexual intercourse. If the cause of the pain is the size and problem of the inner lips, labioplasty is suitable for you. Otherwise it is useless

Mark N. Scheinberg, MD · Answer

Thank you for your questionThere are numerous reasons that women have pain with intercourse and the treatment depends on the cause. If, for example, your pain is due to enlarged labia getting pinched, Then reduction will probably help. I would advise seeing a cosmetic gynecologist and identify the cause of the problem. Once you know why, you can know what to do to resolve your problem.

Adam J. Oppenheimer, MD, FACS · Answer

The inner labia can often become pinched or folded during intercourse, especially when they are elongated or larger. Labiaplasty absolutely reduces this pain in addition to pain with certain garments, exercise and other activities. There is however, pain unrelated to the labia minora known as dyspareunia. This is generally a nonspecific pain but can be related to other anatomical and physiological issues related to the female sexual response. It would be important to be evaluated first before considering Labiaplasty and to make sure that your symptoms are indeed from pinching or pulling of the inner labia tissues. I have performed the Labiaplasty procedure on women in their 50s and 60s before without incident and with great satisfaction to the patient.

Falguni Patel, MD, FACOG · Answer

You mentioned 50.  Are you saying pain wasn’t an issue before menopause?  Because if that’s the case, your labia are not the issue.  Aging is the issue and rejuvenating the tissue is the route you need.  Reducing the labia minor will not make it better or worse.  A proper examination with a gynecologist would be beneficial.  If you’ve done that route and gotten nowhere, then you want to see someone who understands gynecology but also provides treatments outside the box.  For instance, lasers and radio frequency treatments such as core Intima and vaginal Morpheus can improve the function of the vaginal canal and opening, improving sex.  PRP injections in adjunct can also have a great synergistic affect.  Aging often comes with skin conditions such as atrophy, lichen sclerosis, psoriasis to name a few.  Sometimes vaginismus sets in as well…bitch may improve with Botox.  These are things I see everyday in my practice and treating patients with traditional therapy as well as the unconventional route has had great results in improving my patients intimate life.  Labiaplasty would be considered if only you’re having concerns of aesthetic issues.  And at that point, it is very important to seek out a cosmetic Gyn who performs them regularly or a plastic surgeon.  Not all of either do this procedure.  But what good is a pretty “junk” if it’s not functional!  I hope you find intimate wellness soon!

Christine Rodgers, MD · Answer

HI Donita,

A labiaplasty can reduce pain during intercourse IF the labia are the cause for your pain. You need to see a surgeon in your area, whether a plastic surgeon or urogynecologist who specializes in labiaplasties to determine if the labia are indeed the cause of your pain. I cannot give you good advice about this as you have not posted pictures of your labia. Another option is to visit with your gynecologist to determine if their are other cause for your pain. Examples could be a hormonal imbalance, a different anatomic abnormality, or dry vaginal tissue.
Hope this helps a bit,

Best Wishes for you!

Dr. Christine Rodgers

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Some women experience dragging of the labia into the vagina with sexual penetration. Some of these women experience pain due to the dragging. If that describes your situation, then labiaplasty might be an option to consider. If it does not, then you need to see your gynecologist for an evaluation of the many other causes of sexual pain.

Zoran Potparic, MD · Answer

In some patients large labia minora may create problem, discomfort, even pain with intercourse. In person consultation with a board certified plastic surgeon with expertise in labiaplasty, is recommended. Good luck.

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Donita,
Great question, but large labia is not the only reason for painful sex. At 50 many women will experience vaginal dryness which would worsen any other underlying cause. You need a thorough examination to determine if labiaplasty would resolve your painful sex concerns.
Go to the link below to learn more about labiaplasty and other vaginal rejuvenation options. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. 
Best of luck,

Will a labiaplasty help minimize pain during intercourse? What options do I have? 50 y/o

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