What are the best nonsurgical vaginal tightening options?

Question

I've had 5 kids and have some minor incontinence and the inside feels less tight. The outside appearance is fine. I don't want any surgery. I also did pelvic floor therapy but I just can't get the hang of kegels. I'm so self conscience of the looseness! And overwhelmed with all the options. What's available and what's the best?!

Mark N. Scheinberg, MD · Answer

Thank you for your questionThere are two formats for nonsurgical "Tightening". One is radio frequency (eg. Thermiva) and the other is laser (eg. Mona Lisa). Both do the same things: they increase collagen, which is the support tissue and increase blood supply. These two effects help treat 4 issues: 1) reduce stress incontinence (loosing urinewhen you cough or sneeze) 2) reduce urge incontinence (loosing urine when you fell the urge to void) vaginal dryness because of the improved blood supply and 4) by making the vagina stiffer it can create the sensation of being tighter. Only surgery can actually make the vagina narrower. If you are determined to avoid surgery, I prefer radio frequency as it only transmits heat while laser makes multiple little burns to achieve its objective.

Barbara Padilla, MD · Answer

Thank you for your question. At our practice we use Juliet resurfacing for vaginal tightening. This non-invasive laser tightens and tones vaginal tissue by creating controlled microinjuries deep in the skin, which stimulates the body's natural wound repair process. It also creates thermal injury that produces new collagen.

Anna Chacon, MD, FAAD · Answer

For nonsurgical vaginal tightening, several options are available that can help address concerns about looseness and minor incontinence. Here are some of the most popular and effective nonsurgical treatments:

Radiofrequency (RF) Treatments: Devices like ThermiVa and Viveve use radiofrequency energy to heat the vaginal tissue, promoting collagen production and tissue tightening. These treatments are generally well-tolerated, with minimal discomfort and no downtime.

Laser Treatments: CO2 laser (e.g., MonaLisa Touch) and erbium YAG laser (e.g., IntimaLase) are used to stimulate collagen production and improve the elasticity of vaginal tissues. These treatments can also help with symptoms of vaginal atrophy.

High-Intensity Focused Electromagnetic (HIFEM) Therapy: Devices like Emsella use electromagnetic energy to stimulate and strengthen the pelvic floor muscles, which can improve vaginal tightness and reduce incontinence. This option is particularly beneficial if Kegel exercises are challenging.

Platelet-Rich Plasma (PRP) Therapy: Often referred to as the "O-Shot," this treatment involves injecting PRP derived from your blood into the vaginal area to enhance tissue regeneration and improve sensitivity.

Hyaluronic Acid Fillers: Though primarily used for aesthetic purposes, some practitioners use fillers to enhance firmness and elasticity in the vaginal area.

Each of these treatments has its own benefits and considerations, and the best option depends on your specific needs and preferences. It may be helpful to consult with a specialist who can evaluate your condition and recommend the most suitable treatment for your situation.

Michelle Jones Singer, MD · Answer

Based on the symptoms you’re describing, it sounds like the changes you’re feeling are due to the effects of multiple vaginal deliveries. Having five vaginal births can significantly stretch and weaken the vaginal muscles. A vaginoplasty is needed to restore a noticeable sense of tightness.”

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

Unfortunately, it's surgery or nothing. You can waste your time and money or you can read on. Vaginal laxity happens when you sustain damage to the vaginal muscles internally and externally during childbirth. This damage causes a permanent widening of the gap between the muscles (the levator hiatus). However, this is not the only damage that you sustain during childbirth. You also sustain damage to the support structures of the vaginal walls and this damage usually loosens the posterior vaginal wall beneath the muscles (rectocele) contributing to the laxity, and frequently to the anterior vaginal wall (cystocele). Incontinence is a consequence of the latter. With the exception of incontnence, none of these issues can be fixed nonsurgically and none of the nonsurgical treatments with lasers, radiofrequency, or magnetic chairs will work in this setting. It's not what they're capable of doing.

Camille Cash, MD · Answer

There are many options you can consider to help improve the appearance and functionality.  Empower RF offers three nonsurgical options.  VTone, MorpheusV, and FormaV address the vagina, vaginal opening, and labia.  These treatments can be combined with other nonsurgical options such as Aviva which is a scarless labiaplasty and EvolveTite which stimulates collagen to improve appearance.  Visit my website or a provider near you to learn more.

David Ghozland, MD · Answer

The best non-surgical options I’ve seen results with include:

Joe Daniels, MBBS · Answer

I suggest you go for medical grade LVR Therapy/ commonest of those are CO2 Laser Type - Nu-V, Juliet LVR, Mona Lisa Touch, FemiLift- Vagilase /

Robert Jason, MD · Answer

Hello Angelkates,
As Dr. Pelosi stated, you probably only have a surgical option. All the non-invasive options for Vaginal Rejuvenation - Radiofrequency or Laser work very well in the correct candidate for both vaginal tightening and urinary incontinence. However, because you have had 5 children - presumably vaginally - your vagina is probably "too wide" now for the non-invasive therapies to help the vaginal tightening very much. The non-invasive equipment might be helpful, including the O-Shot and the Emsella unit for your incontinence, but probably not enough for improved tightening for sexual gratification. Make sure you are examined by an experienced Cosmetic Gynecologist to help you determine what is best for you.
Robert A. Jason, MD FACOG AACS ISCG

What are the best nonsurgical vaginal tightening options?

Answers (9)

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