Vaginal rejuvenation

A guide to understanding vaginal rejuvenation treatments

The term vaginal rejuvenation encompasses different treatments intended to address functional changes, symptoms and tissue abnormalities affecting the genital area. However, it does not constitute a medical diagnosis in itself. Before selecting a treatment, it is important to identify the underlying cause of the symptoms and assess which options may be most appropriate for each patient.

What symptoms may require gynaecological assessment?

Dryness, burning, itching, irritation, changes in lubrication, discomfort during sexual intercourse and perceived changes in tissue elasticity are common reasons for seeking medical advice.

Urinary symptoms, a sensation of vaginal laxity or pelvic floor problems may also occur. When these symptoms persist or affect wellbeing or sexual health, gynaecological assessment is recommended.

Similar symptoms can have different causes

Vulvovaginal changes may occur during menopause, after pregnancy and childbirth, during breastfeeding or in other circumstances involving hormonal changes.

However, symptoms such as dryness, burning or pain may also be associated with infections, vulval conditions, pelvic floor disorders or other gynaecological problems.

Medical assessment is therefore important to establish the cause of the symptoms before deciding on treatment.

Genitourinary syndrome of menopause

Declining oestrogen levels during menopause can cause changes in the vulva, vagina and lower urinary tract. These changes are collectively known as genitourinary syndrome of menopause.

Symptoms may include dryness, reduced lubrication, irritation, discomfort or pain during sexual intercourse, and certain urinary symptoms. Different treatment options are available, and the choice depends on each woman’s symptoms, medical history and preferences.

Current clinical guidelines include various hormonal and non-hormonal options for managing these symptoms.

Non-hormonal treatments

Vaginal lubricants can be used to reduce discomfort caused by friction during sexual intercourse, while vaginal moisturisers are used regularly to relieve dryness.

Some formulations contain substances such as hyaluronic acid. These options may be used alone or as part of a broader treatment approach, depending on each woman’s circumstances and symptoms.

Local hormone therapy

Vaginal oestrogen is one of the treatment options available for genitourinary syndrome of menopause and can improve symptoms such as dryness and pain during sexual intercourse.

Its action is predominantly local, and the amount of hormone entering the bloodstream is minimal compared with systemic hormone treatments. Different formulations are available, and the most appropriate option is selected according to each woman’s individual circumstances.

Patients with a history of certain hormone-dependent cancers require specific assessment and, where appropriate, treatment decisions should be coordinated with the medical team responsible for their oncology follow-up.

“Different functional and aesthetic vaginal concerns may respond well to vaginal rejuvenation treatments.”

What role do laser and radiofrequency treatments play?

CO₂ laser and radiofrequency are energy-based technologies that act through different mechanisms on vaginal tissues. In recent years, they have been investigated for various symptoms and conditions affecting vaginal health.

Studies of CO₂ laser treatment have reported improvements in certain symptoms, such as dryness or discomfort during sexual intercourse, although the overall certainty of the evidence remains limited. For this reason, some international guidelines continue to recommend caution regarding its routine use for genitourinary syndrome of menopause.

More recent research on radiofrequency has reported favourable results for some outcomes related to genitourinary syndrome of menopause and sexual function. However, further evidence is needed regarding the duration of treatment effects and the most appropriate treatment protocols.

The indication for these technologies should therefore be assessed individually, taking into account the alternatives available to each patient.

Biostimulation, autologous plasma and hyaluronic acid

Hyaluronic acid and autologous preparations, such as platelet-rich plasma (PRP), are used with the aim of improving certain characteristics of vulvovaginal tissues.

Research into these techniques has identified potentially favourable results for different indications. However, there are significant differences between the products used, treatment protocols, number of sessions and outcome measures employed in the studies.

For this reason, their use should be assessed individually, with patients receiving clear information about the results that can reasonably be expected in their particular circumstances.

Pain during sexual intercourse: dryness is not always the cause

Dyspareunia, or pain during sexual intercourse, may be associated with dryness and hormonal changes, but these are not always the underlying causes.

It may also be related to muscular or pelvic floor disorders, vulval conditions, endometriosis, infections, inflammatory conditions or other gynaecological problems.

When pain is persistent, it is important to identify its cause before starting treatment aimed solely at improving lubrication or the characteristics of the vaginal mucosa.

Síntomas urinarios y suelo pélvico

Some urinary symptoms may form part of genitourinary syndrome of menopause, but urinary incontinence can have different causes and requires specific assessment.

Stress urinary incontinence, urgency urinary incontinence and mixed urinary incontinence do not necessarily require the same treatment. Depending on the diagnosis, options may include lifestyle changes, pelvic floor muscle training and rehabilitation, medical treatment or surgical procedures.

When a specific disorder affects the support or function of the pelvic organs, the patient may be assessed by our Pelvic Floor Unit.

Lichen sclerosus: a condition requiring specific management

Lichen sclerosus is a chronic inflammatory condition that frequently affects the vulval area and can cause itching, pain, fissures and progressive tissue changes.

It should not be regarded simply as a vaginal rejuvenation concern. Its management requires specific diagnosis and follow-up. Potent or very potent topical corticosteroids remain the standard treatment, while the use of laser technologies for this condition is still under investigation and does not currently replace conventional treatment.

More information

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