Areas of Concern
The Vulva is the anatomical area that contains the external female genitalia and includes the clitoral hood, clitoris, Labia Minor and Majora, Peineal region and we will extend the anatomy to the Mons Pubis above and anus below. Aging of the vulva, labia or external genitalia such as the labia majora, minora, perineum and mons pubis can occur with age-related changes such as those experienced on the face, neck or body. This may result in the appearance of a wrinkled, deflated Labia Minora and Majora with aesthetic unappealing loss of integrity structure and form.
In addition, there may be hyper or hypopigmentation syndrome leading to brown or white patches and a lack of tissue responsiveness. Additional signs of vulvovaginal atrophy may occur internally leading to pain, dryness, inflammation and discharge, together with painful sexual intimacy.
With age, decreasing estrogen and childbirth, there is often a general loss of tone and elasticity to the soft tissue including vulvar and labial, vaginal laxity with decrease soft-tissue fullness, increasing wrinkling and lack of support of the labia majora and minora. There can be a vulvar dyschromia (increased brown pigmentation) that has colour changes with whitening of areas or patches or hyperpigmentation (brownness) and staining. These light and dark patches can decrease the overall visual appeal of the aging vulvovaginal region. There can also be histological and macroscopic visual changes of vulvar atrophy (thinning), or changes in the skin texture of the labia minora and majora. There can be loss of fullness and thinning of the tissue with wrinkling of the labia majora with those superficial skin growths, dermal papillae or bumps.
Although usually there are minimal functional implications of vulvovaginal aging, there can be some lack of sensory stimulation and discomfort of the introitus, or entrance to the vaginal canal and deflation of the labia major, with loss of firmness and responsiveness of the labia minora.
The prime dissatisfaction of patients with vulvovaginal atrophy is the aesthetic appearance of aging skin and soft tissue. Just like facial aging of the face, neck or body regions, some patients find the aging soft-tissue changes of the vulvar region and labia majora and minora to be aesthetically unappealing and request minimally invasive non-surgical vaginal and labial aging treatments for rejuvenation.
With advancing years and a decrease in estrogen levels, there is a decrease in blood flow. The decrease in blood flow reduces the cellular content of the lining of the vagina and the submucosal tissue. There is decreasing lubrication and mucinous production, resulting in inflammation and dryness, as well as atrophy of the external labia minora and majora with deflation and descent. Age-related changes in pigmentation can also occur.
Physician and internationally recognized cosmetic Plastic Surgeon and lecturer.