Vaginal Laxity

What it is

Vaginal laxity is the feeling that the vagina has become wider or less firm, with reduced sensitivity and pleasure during intercourse, vaginal air escape, and sometimes a feeling of heaviness in the area. It results from stretching and weakening of the pelvic-floor muscles and supporting tissues after vaginal births, with aging, and with the drop in estrogen at menopause. It's a common complaint, rarely talked about, that affects self-esteem and intimacy with a partner. The gynecology team at Femi Saúde assesses the degree of laxity, rules out prolapse, and proposes the appropriate treatment, from physiotherapy to technology-based options and surgery.

Most common symptoms

• A feeling that the vagina is wider or looser
• Less sensitivity and pleasure during intercourse
• Vaginal air escape during intercourse or exercise
• A feeling of heaviness or discomfort in the lower abdomen
• Urine leakage when coughing, laughing or straining
• Difficulty keeping a tampon or menstrual cup in place

Causes and risk factors

• Vaginal births, especially multiple ones or those with large babies
• The drop in estrogen at menopause
• Aging and loss of collagen
• Obesity, chronic constipation and repeated straining
• Genetic predisposition to tissue laxity

How it is diagnosed

The evaluation begins with a conversation about the complaint, the number and type of deliveries, hormonal status, sexual life, and any urinary symptoms or vaginal heaviness. During the gynecological exam, the gynecologist observes vaginal tone and opening, measures the strength of pelvic-floor muscle contraction, and checks for prolapse of the vaginal walls or uterus, which requires its own approach. In some cases, pelvic-floor ultrasound or an evaluation with the physiotherapist rounds out the exam. The choice of treatment depends on the degree of laxity, associated symptoms, and the patient's expectations.

How we treat it at Femi Saúde

Pelvic-floor physiotherapy, with guided exercises, biofeedback, and electrical stimulation, is the first step and strengthens the supporting muscles. The gynecology team at Femi Saúde may add fractional CO2 laser or vaginal radiofrequency, which stimulate collagen production and improve firmness and lubrication in quick, incision-free sessions; at menopause, vaginal estrogen complements the care. In selected cases, when there's marked laxity or associated prolapse, perineoplasty or colpoperineoplasty surgery reconstructs the vaginal opening and perineum. The plan is individualized and determined after clinical evaluation.

What we offer