From vaginal steaming to labial surgery, what do you think about treatments for vagina and vulva health?

It is great that there is a growing trend for women to be more aware of their vagina’s and vulva’s – even a movement to use the correct terms. But I have two concerns; the growing market in vagina/vulva surgery and the growing list of products and procedures we are being bombarded with to allegedly improve our vagina/vulva health.

Do you feel your vagina needs rejuvenating or needs to be youthful (not sure I ever had a youthful vagina), or do you feel that your vulva is abnormal or ugly and you would like to have treatments to change its appearance? There are probably two reasons why women are concerned about their genital appearance; the trend of removing pubic hair and porn. In porn, women often have no pubic hair and very neat vulva, possibly surgically modified. Some women seeing this will question their genital appearance and men may think that women are abnormal. I love this image of the Great Wall of Vagina – celebrating the differences.

I would love to know if you would go through any of the procedures below or if you had concerns about your vagina/vulva, would you visit your GP first?

Vagina/vulva hygiene is obviously important but the vulva/vagina clean themselves.  They produce natural secretions which maintain their health. Our vagina/vulva have their own ecosystem, the vaginal microbiome, which is made up of good bacteria, other beneficial microorganisms and a specific pH. The health advice is that we should only use water or mild, unscented soap around this area and we should not push any fluids up the vagina. Using chemicals or procedures that upset the good bacteria can cause problems.

But vagina/vulva health products, procedures and surgery is a growing trend. There were so many procedures that I have not gone into all the treatments on offer. Here is a highlight.

First I must explain Kegel exercises which is another name for pelvic floor exercises as many companies claim their products reduce your need to do these.  Kegel exercises can prevent or control urinary incontinence and other pelvic floor problems. These exercises strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. They are easy to do and you do not need a gadget to help you.

Products and procedures marketed at vaginal health and beauty

It was announced last year that the vaginal spa is coming to the UK but thank goodness it has not arrived yet. VSPOT have branches in New York and Philadelphia, and the list of treatments they offer frightens me – the comments in brackets are lifted from their web site: vaginal tightening (you’re feeling loose), kegel throne (say goodbye to trying to Kegel), V lightening (want lighter skin around your vagina and inner buttocks?), O-shot (better sex is in your blood – literally), steaming (if you want to feel sexy), V-plump (injects your own blood plasma into your labia majora to rejuvenate and stimulate), femilift (the fountain of life for your vagina), ultra-femme 360 (turn back time) and the vajacial (treat your V to this fabulous spa treatment).

I was interviewed about vaginal spas for an article written by Natalie Gil in Refinery29. I said “”I think most UK women are more aware of their health than in some other countries and I hope they can see the issues surrounding vaginal spas.” Natalie also interviewed  Dr Anne Hendersen, Consultant Gynaecologist who said “I’m very concerned about the prospect of vaginal spas coming to the high street in the UK, effectively normalising the need to seek pseudo-medical and/or cosmetic treatments in the genital area, potentially creating a parallel market similar to the demand seen in the general cosmetic industry.”

Let’s turn to Gwyneth Paltrow and her company Goop. Goop has many non-evidence based treatments, and some involve our vagina’s. NHS chief Simon Stevens has criticised Goop and Gwyneth’s new Netflix series, warning it carries “considerable risks to health”. Gwyneth got in trouble over her claims around vaginal steaming and jade eggs.

Vaginal steaming – When Gwyneth told the world that she did this, some women followed. It involves sitting over a bowl of boiling hot water infused with herbs and is said to “cleanse” and “freshen” the vagina. VSPOT claim this is a ‘natural way to cleanse the uterus, release toxins and old residue. The V-Steam™ at VSPOT is a relaxing, soothing, detoxifying spa treatment for your nether regions that increases your libido, effectively reducing discomfort associated with menstruation. There are many reports in the press where V steaming has caused second degree burns. As reported in The Independent, Dr Vanessa Mackay, spokesperson for Royal College of Obstetricians and Gynaecologists, explains “It’s a myth that the vagina needs extensive cleaning as it is designed to clean itself with natural secretions,” Mackay explains. “The vagina contains good bacteria, which are there to protect it. If these bacteria are disturbed it can lead to infection, such as bacterial vaginosis or thrush, and inflammation.” Steaming the vagina could cause health problems down the line, Mackay adds, because it can affect the healthy balance of bacteria and pH levels, which can lead to irritation, infection (such as bacterial vaginosis or thrush) and inflammation.

Jade eggs – If you look at the Goop UK web site – there are some articles from 2017 about using jade eggs “Jade eggs for your Yoni”  and “12 (more) reasons to start a jade egg practice” but when you click on the links – you do not get to the articles. This is because Goop were taken to court for claiming that putting a jade egg into your vagina for hours at a time could improve your sex life, balance your menstrual cycle, and “intensify feminine energy,”. So now Goop can still sell the eggs but cannot make claims that they will help vaginal health. You can read more in the article in Health. Jen Gunter, MD, a San Francisco-based ob-gyn and author of The Vagina Bible, warns that using a jade egg really could hurt you. “The stones are really porous, so I’m not sure how it could be cleaned or sterilized between uses,” she tells Health. Nasty bacteria (like the kind that cause toxic shock syndrome or bacterial vaginosis) could get lodged in the nooks and crannies, and then get reintroduced into the vagina every time the egg is used, says Dr. Gunter. “That’s especially an issue when one of the recommended ways to use it is sleeping with it in. We don’t recommend that tampons or menstrual cups be left in for longer than 12 hours and those are either disposable or cleanable.”

Luna beads –  You can buy these from Goop for £54.00. It says “Uplevel your Kegels and strengthen your pelvic floor with this modern take on the Ben Wa ball: four beads that come in two different weights for a tailorable experience. Slip them inside your body almost like you would a tampon, and the beads subtly, (and secretly, if you want) vibrate in response to your body’s movements.”

And here are some more treatments….

Radio frequency and lasers to rejuvenate the vagina: In 2018 the FDA wrote an article – “To alert patients and health care providers that the use of energy-based devices to perform vaginal “rejuvenation,” cosmetic vaginal procedures, or non-surgical vaginal procedures to treat symptoms related to menopause, urinary incontinence, or sexual function may be associated with serious adverse events. The safety and effectiveness of energy-based devices for treatment of these conditions has not been established….The treatment of these symptoms or conditions by applying energy-based therapies to the vagina may lead to serious adverse events, including vaginal burns, scarring, pain during sexual intercourse, and recurring/chronic pain.”

Vaginal detox pearls/beads– Helen Nianias wrote a great article about these in Refinary29. She says “vagina detox pearls are these sort of mini spherical teabag things made of muslin cloth and stuffed with herbs such as motherwort, angelica, borneol and rhubarb. You’re supposed to put them up your “vajayjay” in order to sort of cleanse it. It’s claimed – and customers online testify – that they fix lots of different ailments such as bagginess, heavy periods, bacterial vaginosis, hot flushes, endemetriosis as well as a proclivity for yeast infections.” If you want to read a useful article telling you why you should not do this – read Dr Jen Gunter.

Vaginal probiotics. The vaginal microbiome is being studied but we do not know a lot about it. Apparently women are inserting probiotics in their vagina, which  includes both probiotic pills and suppository capsules. In an article by Harvard Medical School, Dr. Caroline Mitchell, assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School said “There is almost no evidence that these have benefit for vaginal health. The studies are mostly poorly done and don’t adhere to rigorous reporting standards, even if they are randomized trials,” says Dr. Mitchell. But that hasn’t stopped companies from promoting products for that purpose.”

Vaginal douching – Vaginal douching is the practice of washing out the vagina with water or douching products which may disrupt the natural secretions and introduce infections.  Douching products may upset hormone regulation in the vagina. In a recent interview with NHS Choices, Professor Ronnie Lamont, spokesperson for the Royal College of Obstetricians and Gynaecologists said: “I can’t think of any circumstances where douches are helpful.”

Genital surgery

Let’s now consider surgical procedures. There are several types of genital surgery – labial surgery or surgery to tighten the vagina to create the designer vagina. In my view, labial surgery can be compared to consenting female genital mutilation. Girls as young as 10 are asking their GPs to be referred for genital surgery as they think they do not look normal. An Australian study, led by Dr Magdalena Simonis from the University of Melbourne’s department of general practice said she believes fashion, online pornography, perceptions of beauty, as well as Brazilian waxes are playing a major role in women’s dissatisfaction with and concern about their genitals. In 2011, one of my colleagues, Professor Sarah Creighton, did a study of women asking for labial surgery and compared their labia with those women attending a routine gynaecology clinic.  You will not be surprised to know that she found no difference in the shape and size between the two groups of women. Sarah Creighton has called for all genital surgery for under 18 year olds to be banned.

If you feel that there is a health problem with your vagina or vulva, please visit your doctor.

Have you ever had any of these treatments or are you considering any? What do you think about companies that are selling and promoting them? I would love to hear your thoughts.

Read more:

The Vagina Bible, Dr Jen Gunter. and watch Jens videos.

Gwyneth has made a series about Goop – the goop lab – on Netflix.

Image credit: The Great Wall of Vagina (which should actually be called the Great Wall of Vulva but that does not have quite the same ring to it).  Reference Jamie McCartney