After three children and the menopause, ‘things’ just weren’t the same. Then a new

There are moments in a woman’s life when dignity becomes a fairly theoretical concept. Childbirth is one, smear tests are another.

And then there is sitting, naked from the waist down, in what looks a bit like a dentist’s chair while a gynaecologist prepares to insert an enormous radiofrequency probe into your vagina.

I was sitting there because, after three children and menopause, things Down There felt loose and floppy and I’d heard this treatment could work wonders to tighten up my internal membranes. Also, girlfriends whispered, it could make sex more, er, satisfactory.

Increasingly, women are starting to talk about vaginal laxity, as doctors call it, not least because there is now a growing industry devoted to treating the changes that happen to the vagina as we age. There are creams, lasers, pelvic floor devices and even home gadgets promising to restore moisture and elasticity…

But, even after all the books and TV programmes about menopause we’ve had in recent years, most women still aren’t exactly eager to discuss what’s happening to their vagina as they age.

It’s a topic that might get raised in the pub on a girls’ night out but not until we’re a few bottles down – and even then with a fair amount of uncertainty.

Yet some women are also starting to understand that we don’t have to put up with it. Treatments for vaginal dryness, laxity and discomfort are becoming increasingly popular, with the use of estriol creams, for example – a topical kind of HRT which aims to restore natural lubrication in the vagina – rising by 400 per cent since 2018 (helped enormously by the new availability of some versions of it over the counter).

Vaginal laxity refers to your internal membranes losing their firmness as oestrogen levels fall. It is especially common after childbirth or during menopause

Thanks to being on HRT since the start of perimenopause 17 years ago, I haven’t had a problem with dryness and still don’t thankfully, but what I am interested in are the kind of one-off clinical v-juvenation treatments that could treat vaginal laxity without the faff of a long-term, at-home regime.

‘Laxity’ is how medics describe what happens when your internal membranes lose their firmness after childbirth, or later during menopause as oestrogen levels fall. Most in-clinic treatments are done with powerful, high-strength radiofrequency or laser energy probes, which trigger repair processes and encourage fresh collagen and healthier mucosal tissue. The catch? They cost around £800 a session and you need at least three.

Increasingly, though, women are starting to look at this as an investment in their health.

The aim of these sessions is to tighten and restore the health of the internal vaginal membranes, which can reduce stress incontinence, providing stronger support for the base of the bladder and the urethra. I don’t suffer from that yet but there’s nothing more miserable, friends say, than worrying about wetting yourself when you’re out and about.

‘Women are definitely becoming more aware of these treatments,’ says consultant gynaecologist Dr Tania Adib, who specialises in menopause care and vaginal health and who I choose to go to for my treatment.

Consultant gynaecologist Dr Tania Adib offers a treatment called TL EmFemme 360 to combat vaginal dryness and laxity 

‘There’s growing acceptance of them, too, although we still have a long way to go. My patients are still nervous talking about their symptoms. They’ll apologise and say, “I’m sorry for the detail, but it’s really itchy and burny”.’

The consequences can be profound, not least for a woman’s sex life. ‘A lot of women come because they can no longer have comfortable sex,’ says Dr Adib.

‘When the tissues become very dry, you can use as much lubricant as you like, but it can still feel like sandpaper. The skin becomes thin, fragile and can even split.’

I know what this laxity feels like, even if I’ve avoided dryness, and was keen to see what her devices could do.

Frankly, as peculiar experiences go, the treatment, which is called BTL EmFemme 360, is next level.

The wand works by blasting radiofrequency energy that heats the vaginal tissues to 40 to 45 degrees celsius, which makes tissues contract and then start renewing themselves.

Trying to remain relaxed when someone you’ve only just met is about to slide something that looks like an overgrown hair tong into the most sensitive part of your anatomy is a big ask.

Most of us have had internal medical examinations, or smear tests, and like those, this feels firmly in the realm of a medical treatment, albeit in rather more luxurious surroundings.

I sit there in a throne-like chair, with a strategically placed towel to somehow make me feel a little less exposed.

I feel extraordinarily nervous but the big surprise is that it doesn’t hurt. In fact I can barely feel a thing. Is there something wrong with me? No, Dr Adib assures me, there aren’t actually that many nerve endings in the vagina itself, only in the lower part of it.

Because the RF energy is beaming out in a full 360 degrees circle, it only takes eight minutes and once I’ve got over the weirdness, I feel genuinely quite relaxed.

After the recommended course of three treatments over three months I am amazed by the tightening effect, which I start to notice after my second session.

It genuinely feels as though everything has been gently hoisted back up towards its original position, which certainly makes sex feel better.

You can have sex a few days after each treatment. I didn’t tell my husband what I was having done until after the second session, at which point I could certainly tell the difference. He said he could too.

For women whose main concern is vaginal dryness, Dr Adib believes the first step should be hormone treatment.

‘Women need to know there is usually a solution,’ she says. ‘It’s about choosing the right combination for the individual.’

Personally I’m happy with my big bang – no pun intended – approach where you get results in just a handful of high-powered sessions. As a means of revving up enjoyment of sex, and helping your internal membranes stay healthy and lubricated for longer, it’s worth the embarrassment.

Joely Hargan is a pseudonym.

Dr Tanya Adib – www.adib.org.uk