The Facts of Life, and Vaginal Tightening
Susan, a 32-year-old mother in Temecula, Calif., sought treatment for urinary incontinence that began after the birth of her children. What she got was an unexpected surprise: better sex.
"My urinary incontinence wasn't severe," she says. "But they say in time it can become severe. My surgeon said he could re-tighten my pelvic muscles and inner walls to solve the problem, and he did."
What Susan didn't know was that the surgery would add new spark to her lovemaking as well. "My husband and I had great sex before, but now it's magnificently great," she explains. "Everything's so much tighter. I can really feel the difference. It's like I'm starting all over again."
Susan is among a growing number of women who are discovering the benefits of surgeries designed to improve sexual function.
"After childbirth, the vagina may become stretched," says Dr. Jane E. Norton, a plastic surgeon in Palm Desert, Calif. "And men get smaller as they age due to less testosterone in their systems, which can affect the size of their erections and their stamina as well. By tightening the vagina, this can enhance pleasure for both the woman and the man."
With childbirth -- and aging -- pelvic muscles relax and the internal and external diameters of the vagina increase. Difficult deliveries can cause serious stretches, tears, and rips -- and generalized weakening of pelvic supports.
It's a price that some women must pay for the reproductive burden of bearing children. If the vagina loses its tone and strength, if the pelvic muscles get too loose, even Olympic-caliber regimens of Kegel exercises won't help much. And sexual pleasure during intercourse may be diminished. In short, a woman won't feel as much sexually. Neither will her male partner.
Gynecologists have long performed surgeries to repair damage caused by labor or trauma. But now, doctors are adapting their surgical techniques to deliver what many patients want: enhanced sex. Los Angeles ob-gyn Dr. David L. Matlock calls the procedure "laser vaginal rejuvenation." The procedure provides a tighter, more resilient vagina, physiologically optimized for lovemaking.
Some women aren't waiting for bladder leakage or pelvic pain before going in for vaginal tune-ups -- they're doing it because they want better sex. Others are doing it to gain greater self-confidence before dating anew after divorce. Still others want a piece of that elusive fountain of youth and are willing to put themselves under the knife or laser -- and pay out of their own pockets -- to get it. In this regard, it's not that different from plastic surgeries like liposuction or breast augmentation.
Dr. Matlock says he does about 25 laser vaginal rejuvenations a month. The surgery costs between $3,500 and $8,000, depending on the specific procedures performed. This includes surgeon's fees, fees for the surgery center, surgical assistant, anesthesia, and pre-op and post-op consultations. It's an outpatient procedure that takes about an hour. Within a couple of weeks of the surgery, women can resume most normal activities; sex is not advised until six weeks have passed.
To many people, the whole concept may seem foreign. In fact, such surgeries have gone on without much fanfare in the Middle East and Asia for many years. But it's not a topic that many American ob-gyns will broach with their patients. And the scientific literature in this area is sketchy at best.
The American College of Obstetricians and Gynecologists, which represents nearly 39,000 physicians, doesn't have an official position on female sexual enhancement surgery. Neither does the American Medical Women's Association, with some 10,000 women physicians of all medical specialties as members. The American Association of Sex Educators, Counselors and Therapists doesn't have an official position, either.
If these medical organizations have nothing definitive to say about the surgery, imagine how baffled the average doctor is about it.
"This is about quality of life," emphasizes Dr. Matlock. He points out that Viagra and other drugs represent only the beginning of a shift away from treatments exclusively for disease toward those designed to enhance well-being, vitality, and yes, even sex.
"These procedures are available to women who want them," says Dr. Norton. "You shouldn't be embarrassed. Sex -- and the joy it can bring -- is a big part of life."
But, say some sex therapists, the procedure shouldn't be considered a sexual panacea. They point out that having a reconstructed vagina will not reconstruct faltering relationships.
"I would be highly suspicious of a quick fix, especially when it's an invasive procedure that carries with it risks that are involved with any type of surgery," says Dennis P. Sugrue, a licensed clinical psychologist and certified sex therapist in Bloomfield Hills, Mich., who is president-elect of the American Association of Sex Educators, Counselors and Therapists.
"The causes of sexual dissatisfaction sometimes can be very complex," he says, "and it's very easy to reduce it down to, say, 'rejuvenate your vagina and you'll rejuvenate your sex life.' But that's too simplistic.
"Before even considering an invasive procedure like vaginal tightening surgery, it's absolutely critical for a woman to consult with a sexual health professional to make sure that the cause of the sexual dissatisfaction is thoroughly assessed and diagnosed. Noninvasive treatment procedures should first be employed. Only if all of those steps are taken and fail to bring about satisfaction should surgery even be considered."
Of course, not all genital surgeries are performed to improve sexual function.
Procedures designed to enhance the aesthetic appearance of the external female genitalia are also gaining in popularity.
Karen, a 25-year-old from San Diego, first noticed her labia minora were too large when she was a little girl.
"I was into athletics, and when we were changing, I could tell what was normal and what was not," she explains. "I just knew that something wasn't right." She says she wasn't unhappy with her body. "It was more of a sense of embarrassment and being shy," she says. "I wished that I was different."
Years passed before she found a doctor who had a track record doing surgeries to reduce labia size (called reduction labioplasties). For a long time, she didn't even know the option was available to her. As it turned out, the reduction was a simple procedure, and she's very pleased with the results.
"I saw eight women last year for this," says Dr. Christine M. Rodgers, a plastic surgeon in Denver. "Some of these ladies have very long labia, which make them feel that they look too old, and they want to look young."
"With the advent of explicit magazines, videos, and apparel, female genitalia are much more on display," notes Dr. William H. Canada, a Las Vegas plastic surgeon. "Women may become self-conscious of their external genitalia's appearance on the beach as well as in the bedroom."
Doctors are now offering a range of surgeries, including unhooding of the clitoris, elevation of the pubis, and more. Patient demand seems be driving these procedures.
"Genital surgery for cosmetic purposes is increasing," says Dr. Gary J. Alter, assistant clinical professor of plastic surgery at the University of California at Los Angeles. "And it's not going to go away."
(WHO'S NEXT TO BE UPTIGHT?!
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