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Need an idea for a New Year's resolution? Rejuvenate your vagina.


If you've had a baby or two or even more, you may be the one in four women who experiences involuntary loss of urine (urinary incontinence) or part of the over 3 million women who has vaginal prolapse (falling bladder, uterus, and/or rectum). And if you have incontinence or prolapse, it's also likely that you've been putting up with these symptoms for a while wondering how and when you can take care of these bothersome issues. Well don't wonder anymore -- the new year is the perfect time to finally take care of your intimate parts.

Vaginal rejuvenation is not one medical procedure but an all-encompassing term that includes things like procedures to treat incontinence, lifting of the bladder, vaginal tightening, and reshaping of the labia. Regardless of how the term is used, the basic premise is tidying up things down there so that you can have a happy, healthy, functioning vagina. It's very important to keep in mind that a happy, healthy, functioning vag is relative. How you view your vaginal health should be compared to the old saying regarding beauty -- it's in the eye of the beholder, i.e. if you are happy with your vagina and as far as you're concerned nothing is wrong down there, then stop reading and find another New Year's resolution; but if you aren't happy with what's going on in that area, then read on...

There are two main types of urinary incontinence: stress incontinence and urge incontinence. Stress urinary incontinence is leakage of urine with physical (not emotional) stress such as coughing, laughing, and jumping and is commonly caused by vaginal childbirth. Treatment options include observation (keeping an eye on things) if the incontinence isn't that bothersome, Kegel exercises or pelvic floor physical therapy, and surgery. Thankfully surgery for stress incontinence has improved over time so that it's typically a same-day (outpatient) procedure and you can resume exercise within a few weeks of surgery. Urge incontinence, also known as overactive bladder, is loss of bladder control associated with an overwhelming urge to urinate. This is most commonly due to aging, hormonal changes, certain neurologic conditions, and pelvic surgery. The non-surgical treatment options of observation, Kegel exercises, and pelvic floor physical therapy are the same as for stress incontinence, but urge incontinence is often treated with overactive bladder medication, Botox injections into the bladder, and neuromodulation (pacemaker for the bladder).

Pelvic organ prolapse is when one or more of the pelvic organs (bladder, uterus, colon) falls into the vaginal canal. Like stress incontinence, this is also usually due to vaginal childbirth. A woman might feeling pelvic heaviness as the day progresses or even see or feel a bulge coming out of her vagina. Also like incontinence, this is not life-threatening just potentially alarming and annoying. Prolapse that is mild can be observed, Kegel exercises and pelvic floor physical therapy can be helpful, and a bonus of surgery for prolapse is that invariably the vagina gets tightened when the organs are lifted. During childbirth, the muscles and connective tissue of the pelvic floor get stretched and torn which allows the pelvic organs to "fall" and also makes a woman's vagina feel larger. Prolapse repair brings the muscles and tissues back together and thus "tightens" the vagina. And while prolapse and incontinence procedures are considered elective, meaning they have a medical necessity but are not urgent conditions, they are not considered cosmetic and are usually covered by insurance; however, if a woman just wants vaginal tightening and there is no prolapse diagnosis then the procedure could be considered cosmetic and not covered by insurance (although this would be very unusual as a woman's vagina almost always becomes lax due to prolapse).

And what if you don't like the appearance of your labia? Join the club since very few women look like Barbie down there. Unless there is a lot of extra labial/vulvar tissue that is causing pain or interfering with sexual activity, labiaplasty or labial reduction is generally considered a cosmetic procedure and not covered by insurance. The good news is it's a minor procedure so the cost can be reasonable.

What are you waiting for? 2022 is the year to celebrate you by taking care down there.


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