Celebrity hype about vaginal rejuvenation confuses proven treatment with puffed up promises

People Magazine, the Daily Mirror and even the Ottawa Sun published stories earlier this summer when actress Jada Pinkett Smith disclosed she went for treatment on her "yoni," as she called it.

The headlines used were similar in that they all included the term "vaginal rejuvenation."

"It looks like a little beautiful peach," the 46-year-old celebrity was quoted to have said, though she cited incontinence troubles as her initial reason for seeking out the treatment. The brand-new look was ostensibly a bonus.

About a month later — perhaps by coincidence, but certainly in response to increasing requests for vaginal rejuvenation — the U.S. Food and Drug Administration (FDA) put out a warning:

"We've recently become aware of a growing number of manufacturers marketing 'vaginal rejuvenation' devices to women and claiming these procedures will treat conditions and symptoms related to menopause, urinary incontinence or sexual function," FDA Commissioner Scott Gottlieb said in a statement.

"The procedures use lasers and other energy-based devices to destroy or reshape vaginal tissue. These products have serious risks and don't have adequate evidence to support their use for these purposes. We are deeply concerned women are being harmed."

Vaginal rejuvenation is poorly defined. The term is used to describe both surgical and non-surgical techniques to improve vaginal laxity and sexual satisfaction. (Credit: iStock/Getty Images)

I'm worried too. As a gynecologist for the last 15 years, I've seen an increase of women coming in thinking there's something wrong with how their vulva looks, no doubt influenced by stories of high-profile celebrities preening about their refreshed peaches.

Indeed, in recent years, my colleagues and I have noted the proliferation of vaginal rejuvenation, which has rapidly become a multi-million dollar industry.

Vaginal rejuvenation is poorly defined. The term is used to describe both surgical and non-surgical techniques to improve vaginal laxity and sexual satisfaction. The concern I have, and the one I share with my colleagues, is that there is insufficient scientific evidence as to the efficacy of these laser procedures.

Nevertheless, vaginal laser therapy is being touted as a fix-all for both medical and cosmetic procedures, due in no small part to celebrity preening about its miraculousness.

Wild west of women's southern hemisphere

In Canada, vaginal rejuvenation is a largely unregulated field, where different types of providers — anyone from a spa owner to medical doctor — can buy and use many types of lasers. The laser companies will sell the devices to practically anyone who wants to give it a go; call it the wild west of women's southern hemisphere.

Yet there are very specific lasers that have been shown to treat some medical conditions. Certain lasers — YAG lasers, as opposed to radiofrequency lasers — show promising evidence for treating urinary incontinence. Then there's the CO2  laser, which is used in the treatment of GSM, or genitourinary syndrome of menopause. This condition includes dryness, itching, burning and pain during sexual activity, which are common symptoms for menopausal women, but can be extreme and debilitating for some patients.

For a long time, the only treatment for this common condition was long-term vaginal estrogen, which many women would prefer not to use for a variety of reasons, including hormonal effects and the inconvenience of having to topically apply a cream regularly.

So at the beginning of this year, my medical partners and I started using a CO2  ablative laser called the Mona Lisa Touch (we're not fans of the name by the way, and refer to it as MLT), which is only sold to gynecologists (a regulation set by the company). It has the same effect in treating GSM as the estrogen option, including improvements in lubrication, blood flow and elasticity.

The MLT is currently being used in a handful of academic centres and clinics in the U.S. and Canada, with data from various studies indicating up to an 85 per cent improvement in atrophy, restoring the structure of the tissues to a pre-menopausal state.

The laser is the only one approved by Health Canada specifically for GSM. It is very likely not the same laser that is currently being advertised in the window of your neighbourhood spa — the one that promises everything from tightening, to softer skin, to treatment for urinary incontinence — and it comes with scientific backing behind it.     

We shouldn't confuse largely unregulated cosmetic procedures with very specific treatments, using specific lasers, for diagnosed conditions. Best wishes to Pinkett Smith and her revitalized "yoni," but as with most things that come from Hollywood, we should take her claims with a healthy dose of skepticism.

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.

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