Understanding your concerns

Common causes and contributing factors

Several factors may contribute to changes in vaginal sensation or pelvic support.

Pregnancy and childbirth

Pregnancy places additional demands on the pelvic floor, and vaginal birth can affect the muscles, connective tissues and nerves involved in pelvic support.

Experiences vary considerably. Some people notice changes after childbirth, while others do not. The presence of a change does not necessarily indicate an injury or a condition requiring treatment.

Ageing and menopause

Ageing and changes in hormone levels, particularly around menopause, can affect vaginal tissue characteristics, lubrication and comfort.

Vaginal dryness, irritation or discomfort may occur alongside changes in sensation. These concerns should be assessed individually rather than assumed to have a single cause.

Pelvic floor muscle function

The pelvic floor muscles help support the bladder, bowel and pelvic organs. Changes in muscle strength, coordination or function may contribute to altered sensation, urinary symptoms or a feeling of reduced support.

Connective tissue and individual anatomy

Genetic factors, connective tissue characteristics and natural anatomical variation can influence pelvic support.

Other contributing factors may include previous pelvic surgery, chronic constipation, persistent coughing and activities that place repeated pressure on the pelvic floor.

Assessment

What does a vaginal laxity assessment involve?

An assessment begins with a discussion of your symptoms, medical history and personal concerns.

Depending on your circumstances, your doctor may ask about:

• Pregnancy and childbirth history.
• Menstrual and menopausal changes.
• Urinary and bowel function.
• Sexual comfort and any associated pain.
• Previous pelvic procedures or surgery.
• Current medical conditions and medications.
• The nature and duration of any changes you have noticed.

Where clinically appropriate, an in-person examination may be recommended. This can include an assessment of vaginal tissues, pelvic floor function and signs of pelvic organ prolapse.

An examination is undertaken only where appropriate and with your informed consent.

Your doctor may recommend further investigations or referral to a pelvic health physiotherapist, GP, gynaecologist, urogynaecologist or another relevant specialist.

Not everyone requires an examination, procedure or ongoing treatment. The appropriate next step depends on the symptoms and findings.

Treatment options

Treatment and management options

There is no single treatment suitable for everyone who describes vaginal laxity.

Management depends on whether there is an underlying medical condition, the symptoms experienced, the available evidence and your individual preferences.

For some people, reassurance, education and observation may be appropriate.

Pelvic floor physiotherapy

Pelvic health physiotherapy may be recommended when pelvic floor muscle function contributes to symptoms.

A qualified pelvic health physiotherapist can assess muscle strength, coordination and relaxation and develop an individualised management plan.

Pelvic floor exercises are not necessarily appropriate in the same form for everyone. Some people experience pelvic floor overactivity or pain and may require a different approach.

Conservative and lifestyle measures

Depending on the findings, conservative management may include:

• Education about pelvic anatomy and normal changes.
• Management of constipation and persistent coughing.
• Appropriate physical activity and pelvic floor support strategies.
• Assessment of urinary or bowel symptoms.
• Monitoring symptoms over time.

These measures are selected according to individual needs and are not intended to alter normal anatomy for cosmetic reasons.

Management of menopausal changes

When vaginal dryness, irritation or discomfort is associated with menopause, a doctor may discuss appropriate management options.

These may include non-medicinal measures, suitable vaginal moisturisers or lubricants, or medical treatments where clinically indicated.

Any medicine requires an individual assessment of potential benefits, contraindications and risks.

Specialist and gynaecological assessment

Where symptoms suggest pelvic organ prolapse, significant pelvic floor dysfunction, persistent urinary incontinence or another gynaecological condition, specialist assessment may be appropriate.

A gynaecologist or urogynaecologist can discuss further investigation, conservative treatment and, in selected circumstances, surgical options.

Surgery is not routinely indicated for a subjective feeling of vaginal laxity. Any surgical recommendation requires a diagnosis, consideration of alternatives and a discussion of potential complications.

Non-surgical procedural approaches

Some non-surgical procedures have been investigated for vaginal and genitourinary symptoms, including energy-based and injectable approaches.

Potential complications of invasive or energy-based procedures may include pain, bleeding, infection, burns, scarring, altered sensation and discomfort during sexual activity.

Géniale Intimate does not recommend a procedure solely because someone notices normal anatomical changes. Any proposed intervention must be considered against the available evidence, applicable Australian regulatory requirements and individual clinical findings.

Medical references

References and further reading

• Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) — Clinical guidance and statements concerning pelvic health, menopause and female genital cosmetic procedures
• Continence Health Australia — Information about pelvic floor health, urinary incontinence and pelvic organ prolapse
• Jean Hailes for Women’s Health — Women’s pelvic health, menopause and vaginal health information
• Australian Health Practitioner Regulation Agency (Ahpra) — Guidelines for advertising a regulated health service