Americanized Female Genital Mutilation

Image: Shutterstock/Munimara

Recently the FDA urged caution regarding the use of “vaginal rejuvenation” devices that are being marked to improve vaginal lubrication, sexual function, and control of urinary incontinence. They cite the lack of scientific evidence to support these claims as well as reports of vaginal burns and scarring. This procedure, which uses laser or other energy sources, is marketed to women in upscale communities who are willing to pay thousands of dollars out of pocket to modify their female genitalia for a presumed improvement in sexual function.

Vaginal rejuvenation is a newly minted term that has no medical basis. It is variously described.

  1. “ One of the most performed procedures for vaginal rejuvenation is called labiaplasty, a surgical procedure that reshapes and/or removes excessive labia minora tissue (the skin covering female clitoris and vaginal opening also known as the innervaginal lips).”
  2. “The purpose of vaginal rejuvenation is to tighten the vagina for increased friction resulting in greater stimulation during intercourse.”

Female circumcision, performed in many West African countries, can be described as removal of part of the labia to tighten the vaginal introitus, increasing friction for the male partner and making intercourse more enjoyable as well as proving that the woman is virginal at marriage. We may be horrified at this description, as it is often performed on young girls without their consent, but how does the procedure differ that much from the description of vaginal rejuvenation described above?

The marketing to women of products and procedures that would improve their sexual function started in the 1940’s with the original advertising of Lysol as a douche to safeguard a women’s feminine allure by cleansing the vaginal canal and eliminating objectionable odors. Lysol was touted as being gentle and non-caustic, preventing harm to delicate tissues. It soon became the #1 selling feminine hygiene product as women were misled into believing that it would prevent their husbands from developing a “wandering eye” at the same time as increasing their femininity, self-confidence, and poise.

We now laugh at this outmoded practice and have a hard time believing women would douche with Lysol more than once. But at least Lysol was inexpensive and done in the privacy of your own home. Before vaginal rejuvenation, women shaved part of their pubic hair during bikini season so that it couldn’t be seen outside of their increasingly minimalist bikinis. Before long, all of the pubic hair was being removed, albeit in the privacy of your own home. Then marketing got involved and “waxing studios” started popping up everywhere. Any pubic hair was now considered unclean, unsightly and would embarrass you during sexual relations so it needed to be removed by a professional on a regular basis. As women started removing all of their pubic hair and porn became one of the top viewed items on the internet, suddenly women could compare their genitalia with what was depicted as the ideal. Thus the development of labiaplasty and vaginal rejuvenation.

As a gynecologist, I see the unmarketed side effects of these procedures. Pubic hair is meant as a first line barrier to prevent irritation of the vulva and impede the spread of infection. When this hair is shaved or waxed, it can lead to folliculitis and contact dermatitis. Douching, with or without Lysol, destroys the normal bacterial population of the vagina, increasing the risk of BV, yeast infections, and STDs. Labiaplasty and vaginal rejuvenation can cause scarring that makes sex more uncomfortable.

Women shouldn’t need the FDA to caution them against a costly procedure that is simply done to make themselves more attractive to men. In the age of the #metoo movement and women’s empowerment, women need to stand up for themselves because our society has proved that there will simply be another trend when this one has lost favor.

Dr. Leslee Jaeger is an ob/gyn and a 2018–2019 Doximity Author. She is also a mom to 3 bio and 2 adopted children, advocate for women’s health domestically and internationally, and loves good food and good books. She currently blogs about her family and work at jaegerleslee.wordpress.com.

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