Do Energy-Based ‘Vaginal Rejuvenation’ Procedures Work?

While research is expanding, many experts still urge caution.

a young woman of color speaks with her doctor, a middle aged Black woman

Medically reviewed in June 2022

Updated on June 28, 2022

Vaginal rejuvenation is a catchall term used to describe procedures that are marketed to women who have experienced issues caused by childbirth, aging, or menopause.

After giving birth, for example, women may experience laxity (or lack of tightness) of the vagina. During menopause, estrogen levels drop, causing vaginal atrophy (which may lead to loosening of the vaginal walls), as well as tissue thinning and drying of the vaginal walls. Women may also experience vaginal itching, trouble urinating, painful sex, and decreased sexual sensation.

Energy-based vaginal rejuvenation products and procedures promise to alleviate symptoms like these. The problem is that while some research suggests that these nonsurgical procedures may be safe and effective in the short term, their long-term effectiveness and safety is unknown.

What is ‘vaginal rejuvenation’ and is it safe?
Each type of energy-based vaginal rejuvenation device works differently, but in general, “energy-based” devices fall into the two general categories: those that work using lasers and those that use radiofrequency.

Laser devices involve inserting vaginal probes that deliver laser energy to the vaginal wall. This can stimulate the tissue to make more collagen, resulting in firmer skin. Radiofrequency energy devices use focused electromagnetic waves to generate heat that is said to help tighten vaginal tissue.

In large part because of the lack of data around vaginal rejuvenation products and procedures, the U.S. Food and Drug Administration (FDA) released a statement in late July 2018 warning women who are considering having vaginal rejuvenation or cosmetic procedures using lasers or radiofrequency devices to be aware of the potential for serious side effects. The FDA also sought to put healthcare providers (HCPs) who use energy-based devices to perform these procedures on notice, as well. The FDA wanted physicians and patients to know that these devices are not approved as treatment options for symptoms including vaginal dryness, urinary incontinence, or sexual dysfunction.

Understanding the risk of side effects
According to the FDA, not only do these devices lack approval for treatments related to vaginal rejuvenation, but their use in this way could result in burning, scarring, and short-term or recurring pain.

It’s worth noting that the FDA’s statement did not apply to surgical procedures that are also referred to as “vaginal rejuvenation.” But these surgeries, which may be done to tighten the vagina for cosmetic reasons, are also not without controversy. The American College of Obstetricians and Gynecologists (ACOG) has warned in the past that there’s usually no medical reason to do them.

Research is evolving
Since the FDA’s warning, more research has begun to paint energy-based vaginal rejuvenation in a somewhat more favorable light.

One review of 76 studies published in 2021 in Current Sexual Health Reports concluded that recent studies with improved study design suggest that the use of energy-based devices may provide improvements in functional vaginal problems with rare occurrence of serious side effects. The authors noted, however, that some concern still remains regarding their long-term safety.

One 2022 study published in Lasers in Medical Science showed some benefits of radiofrequency to help with sexual function, but the authors noted that further studies with more participants are needed to confirm the value of the procedures for the population at large. Another small study of 16 women published in 2021 in Annals of Translational Medicine showed some benefits from laser treatment to women with vaginal laxity, but the researchers recommended the procedures only for women with mild symptoms. Both studies note that Kegel exercises can also help improve symptoms.

Resources for treating menopause symptoms
Urinary incontinence, vaginal atrophy, and pain during intercourse are common symptoms during perimenopause (the period of roughly 10 years before one’s last menstrual period) and menopause. ACOG recommends the following treatments to help ease symptoms:

  • Topical medication (such as vaginal estrogen) to help maintain lubrication and elasticity
  • Pelvic floor physical therapy
  • Counseling
  • Kegel exercises to help strengthen the pelvis and related muscles

Yoga can improve sexual function by strengthening pelvic floor muscles. It can also help with urinary incontinence that comes as a result of menopause, according to gynecologists who specialize in urinary issues.

If you’re considering treatment options for symptoms related to menopause, urinary incontinence, or sexual dysfunction, talk with an HCP about the best options for you. If you’ve heard about energy-based vaginal rejuvenation and are considering it, check with a trusted HCP to see if they recommend it. They can advise if you fit the profile of a patient who might benefit from such a procedure.

Meanwhile, if you’ve had a vaginal rejuvenation using a laser or radiofrequency device and are experiencing any problems like pain or burns, the FDA recommends filing a report through MedWatch, also known as the FDA Safety Information and Adverse Event Reporting Program.

Article sources open article sources

U.S. Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D., on efforts to safeguard women’s health from deceptive health claims and significant risks related to devices marketed for use in medical procedures for “vaginal rejuvenation.” July 30, 2018.
Bujnak, A., Crowder, C.A. & Krychman, M.L. Energy-Based Devices for Functional Vaginal Problems: Issues and Answers. Curr Sex Health Rep 13, 1–13 (2021).
Cleveland Clinic. Energy-Based Treatments and Vaginal Rejuvenation. Last reviewed April 13, 2018.
Wattanakrai P, Limpjaroenviriyakul N, Thongtan D, Wattanayingcharoenchai R, Manonai J. The efficacy and safety of a combined multipolar radiofrequency with pulsed electromagnetic field technology for the treatment of vaginal laxity: a double-blinded, randomized, sham-controlled trial. Lasers Med Sci. 2022 Apr;37(3):1829-1842.
Cheng C, Cao Y, Ma SX, Cheng KX, Zhang YF, Liu Y. The strategy for vaginal rejuvenation: CO2 laser or vaginoplasty?. Ann Transl Med. 2021;9(7):604.
US Food & Drug Administration. MedWatch: The FDA Safety Information and Adverse Event Reporting Program. Accessed May 25, 2022.
American College of Obstetricians and Gynecologists. Vaginal Rejuvenation, Labiaplasty, and Other Female Genital Cosmetic Surgery. Last updated April 2021.
The Continence Center. Yoga positions to strengthen pelvic floor muscles. Visited May 24, 2022.
American College of Obstetricians and Gynecologists. Pelvic Floor Problems. 2022.

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