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Vaginal Laxity is taboo! Women are reluctant to talk about it because they think it is embarrassing! Many women suffer in silence. They are convinced that the condition of vaginal laxity is part of the natural ageing process and that is inevitable to happen and there is nothing that would correct it but surgery. 
They struggle with a decrease in sexual satisfaction due to lack of enough physical friction during intercourse, (due to loose vaginal opening and the surrounding muscle tone) and diminished or loss of sensation and natural lubrication function. 
This elicits the symptoms of pain during intercourse (dyspareunia) or sensation of “cactus dryness” or irritation or burning sensation or uncommon cracks in the vaginal wall with the occurrence of spotting or bleeding following intimacy. 
The combination of all these symptoms comes under the terminology or the diagnosis of Vulvo-Vaginal Atrophy (VVA) or Genitourinay Syndrome (GSM) is a combination of <a title="vulvovaginal laxity" href="/treatment/non-surgical-vulvo-vaginal-rejuvenation/" target="_blank" rel="noopener">vulvovaginal laxity</a>, vaginal atrophy, urinary incontinence, and orgasmic dysfunction). 
The GSM symptoms include genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections 10-12
 
Vaginal Laxitys: How to Treat
I) Surgical Treatment 
Vaginal Laxity can be treated by traditional surgical procedures called vaginoplasty (Anterior Coloporrahpy, Posterior Colpoperineorrahpy, Manchester-Fothergill repair, perineoplasty and vaginal vault prolapse etc. The surgical option requires lengthy preparation, anaesthesia, stay in the hospital and a long time for recovery, not to mention the inherent risks of surgery and potential complications including <a title="scar" href="/conditions/scarring/" target="_blank" rel="noopener">scar</a> tissue formation. 13-15
 
Female Sexual Dysfunction Following Vaginal Surgery
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A significant percentage of women report pain during intercourse. Some patients experience improved overall sexual function due to complete relief from coital incontinence.
It is worth mentioning that the purpose of surgery is achieving anatomical tightening of the vaginal wall, but it does not lead to improvement in the function or the quality of the already atrophic vaginal tissues.16, 17
 
II) Non-Surgical Options: What are They?
1) Conservative
1.1. Pelvic Floor Exercises (Kegel’s)/Physiotherapy 
These aim to tighten the muscles surrounding the vaginal opening and improve the resting muscle bulk and tone. These exercises should be routinely done at least 3 times a day for 10-15 minutes daily and indefinitely.18, 19
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1.2 Hormonal Replacement Therapy - How Useful is VVA? 
The use of Oestrogen <a title="Hormone Replacement" href="/treatment/bio-identical-hormone-replacement-therapy-treatment/" target="_blank" rel="noopener">Hormone Replacement</a> (EHT) is meant to improve and reverse the atrophic changes happening in the vaginal wall. It improves the quality of vaginal tissues enhancing blood flow and thickening and abundance of the cellular element of the lining vaginal skin; an effect mediated by the Oestrogen receptors. Topical applications are usually advised to avoid or minimise the side effects. Forms like Creams, pessary, and vaginal rings are usually prescribed to be applied for a two or three month-course that can be repeated every 3 months. 
Vaginal Laxity is not expected to be improved by the ERT, but the lubricating function will be regained.20-22
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What Are the New Trends in Non-Surgeical Treatment of Vaginal Laxity?
1.3 Non-Hormonal Non-Surgical Aesthetic/Regenerative Gynaecology procedures
Nowadays most women are choosing the non-surgical “Aesthetic” better called “Regenerative Gynaecology” TM options such as the use of Hyaluronic Acid <a title="Fillers" href="/treatment/dermal-filler-injections" target="_blank" rel="noopener">Fillers</a> or autologous cell grafting or autologous lipofilling, Gold Thread Implantation radiofrequency and laser; all these aiming to tighten and rejuvenate vaginal tissues.23-28
<a title="Platelets’ Rich Plasma Injections" href="/treatment/prp-sexual-rejuvenation-p-shot-o-shot/" target="_blank" rel="noopener">Platelet Rich Plasma Injections</a> (also known as O Shot): the use of an autologous platelets sample after centrifuging the person’s blood sample and injection in certain points -by the experienced Gynaecologist Dr Nadia Yousri- to stimulate tissue regeneration and vaginal rejuvenation. It has excellent results with the expert hand. Platelet-rich plasma (PRP) can be incorporated into <a title="genital rejuvenation" href="/conditions/genital-surgery" target="_blank" rel="noopener">genital rejuvenation</a>.29-34
The use of PRP as a supplement to cell culture media has consistently been shown to potentiate stem cell proliferation, migration, and differentiation. In addition, the clinical utility of PRP is supported by evidence that PRP contains high concentrations of growth factors (GFs) and proteins which contribute to the regenerative process. PRP-based therapies are cost-effective and also benefit from the accessibility and safety of using the patient's own GFs. In the last years, great development has been witnessed in PRP-based biomaterials, with both structural and functional purposes.
Genital rejuvenation involves the management of extrinsic (traumatic) and intrinsic (ageing) changes in the vagina and scrotum. Lipofilling-with the additional injection of PRP (with or without hyaluronic acid)-has been used to successfully treat vaginal atrophy and vaginal laxity; the unexpected resolution of Lichen Sclerosis in one of the women prompts the consideration to initially use PRP for the treatment of this condition not only in women but also men.35-38
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