The vagina anatomy ages and can change as you get older just like any other part of the body. Pregnancy, birth, and hormonal shifts that occur with menopause can all change the look and feel of the vagina. Experiencing these changes can be startling. For many women, experiencing dryness, laxity, or changes in appearance can cause feelings of discomfort and self-consciousness. While change is normal, it’s important for women to understand that they have options for vaginal restoration and rejuvenation to help them feel more like themselves again. Of course, speaking with a doctor specializing in women’s health is also important to rule out anything more serious than age-related changes if you’re noticing changes in your sexual health.
THE VULVA (EXTERNAL GENITALIA)
Vulva refers to the visible outer genitalia that is most commonly referred to as the vagina. This includes the labia majora, labia minora, clitoris, and the vaginal opening. The vulva is where most of the changes can be easily noticed as you age.
The Labia
The labia majora and labia minora are folds of skin surrounding the vaginal opening. While the labia majora are the more visible outer lips, the labia minora are the interior lips under the opening of the vagina. The labia can be smooth, short, long, or wrinkled at any age. However, some women notice that they can become longer, darker, and more pronounced as time goes on. There are many simple aesthetic options for changing the appearance of the labia. For example, many women who experience dryness or “wrinkling” with time opt for labia puffing procedures that involve injecting fillers or grafting fat into the labia for a plumping effect. In addition, genital bleaching can reverse darkening or “greying” of the skin of the labia.
The Clitoris
While the clitoris does not go away with age, many women notice that this portion of vulva anatomy begins to shrink or become less prominent during menopause. The hormonal effect of menopause on women commonly leads to something called urogenital atrophy that actually shrinks the clitoris. For women who are dissatisfied due to aesthetic or arousal issues, a procedure called a clitoral hood reduction can remove excess tissue from the clitoral hood to leave more of the clitoris exposed. Another option for reviving the clitoris is a G-spot injection. This procedure injects platelet-rich plasma (PRP) from your own blood into the clitoris and G spot to promote cell and tissue regeneration.
The Vaginal Opening
Many women experience vaginal laxity within the vulva anatomy after giving birth. It’s also common for laxity to begin as a result of hormonal changes during and after menopause. In addition to decreasing sexual satisfaction, vaginal laxity can create an uncomfortable feeling of looseness and lead to urinary incontinence. For women struggling with vaginal laxity, vaginal tightening procedures can help to restore comfort and enjoyment.
Depending on the level of invasiveness you’re comfortable with when choosing a procedure, your doctor can offer everything from vaginal exercises to surgery. A vaginoplasty is a surgical option that restores vagina anatomy by repairing muscles and soft tissue. It is often preferred by women because of its long-lasting results and ability to improve sexual response and sensitivity. If you are more interested in exploring nonsurgical vaginal rejuvenation options, radiofrequency or laser treatments can be used to trigger collagen production in the tissue within the vagina anatomy. Unlike surgery that instantly repairs tissue, laser options promote the gradual rebuilding of new cells. If you don’t feel ready to commit to a procedure, your doctor can recommend Kegel exercises and other movements designed to strengthen the pelvic floor muscles.
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THE VAGINA (INTERNAL ANATOMY)
The vaginal canal is the muscle tissue that is about 5 inches and connects the vulva or external genitalia to the uterus. The vaginal walls are elastic, with a lot of blood vessels, and very absorbent, hence why medication is sometimes administered intravaginally.
The Vagina
Over time, the interior vaginal walls can thin out. You may experience dryness, drooping, or a noticeable decrease in the number of contoured folds within the walls. Additionally, you may feel a reduction in muscle tone within the vaginal walls that leads to decreased sensation. These changes are largely due to estrogen dips that occur with age. In many cases, hormone therapy in the form of a patch or cream can be used to balance estrogen levels. Additionally, vaginal laser rejuvenation can offer a noninvasive way to encourage the restoration of collagen in vaginal tissue to begin “building up” the vaginal walls once more.
The Cervix
The cervix is located at the lower end of the uterus. In addition to allowing menstrual blood and other fluids to flow from the uterus to the vagina, the cervix widens during childbirth. Some women experience cervical discomfort and irritation following childbirth. These issues can generally be resolved with pelvic-floor exercises. If discomfort persists, it’s crucial to speak with a doctor about having an examination called a colposcopy performed to look for abnormal cells. If something looks suspicious, a loop electrosurgical excision procedure (LEEP) can be performed to remove irregular cervical tissue.
Uterus
Located between the rectum and bladder, the uterus is a pear-shaped organ where conception and gestation take place. Pregnancy isn’t the only time when the uterus undergoes major changes. During menopause, it’s common for the uterus to shrink substantially in size. The uterus can also change due to adhesions caused by surgery or various gynecological diseases.
Ovaries
The ovaries are almond-sized glands located on either side of the uterus in the lower abdomen that produce eggs and reproductive hormones. With age, ovaries begin to produce lower amounts of estrogen and progesterone as they shrink in size. Women who experience primary ovarian insufficiency (POI) may benefit from hormone replacement therapy (HRT) and supplementation.
Do you have questions about your reproductive health? Dr. Michael Tahery is a leading board-certified obstetrician-gynecologist (OB/GYN) and urogynecologist in the Los Angeles area. Book an appointment today.