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By Dr. Tiger Devore

As people age, many struggle with changes in the body that reduce the desire for sex. For women, lack of sexual desire is the most common complaint in the office of the sex therapist. When women go to a medical doctor with this complaint, they can be offered an array of possible options for how they might increase their sexual desire, from pills to creams to hormones, all intended to help a woman to feel more interest in sex.

It is true that with age, a woman’s vagina loses tone and tightness because of a natural stretching in the muscles and tissues at the base of the pelvis, as well as stretching of the muscles of the vagina that occurs as a result of childbirth. This can cause a feeling of widening of the vagina, resulting in a loss of sensitivity for both the woman and her intimate partner. Also, as weight gain becomes more stubborn with age, the lower abdomen enlarges and sags, which, for many, makes the female genitalia less appealing in appearance. If a woman perceives these changes as causing her to look genitally unattractive, that perception can reduce her sexual desire and excitement, and threaten her sexual self esteem, causing her to avoid or not enjoy sex.

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Cosmetic surgery can offer a solution for these changes, just as it does in liposuction, breast augmentation, face- and neck-lifts, or any aesthetic surgical procedure. These surgeries, called genital rejuvenation or vaginal rejuvenation, can improve the appearance of the genitals and increase sensation for both the woman and her intimate partner. This can have both a positive functional and psychological effect: If a woman feels that her genitals are more attractive and her partner finds them so as well, desire for sex can increase for both.

These surgeries fall most commonly into three types: vaginoplasty, which is a reconstruction of the vagina to tighten it; labiaplasty, usually to reduce the size of labia that are perceived to be too wide or loose; and hymenoplasty, which is a reconstruction of the hymen, to give the genitals a pre-sexual appearance. If there are no complications, these surgeries can have the effect they are intended to produce.

It’s important to remember that there are risks with any surgery. Complications for female genital surgery can be very bad. Pain after surgery can be severe, and sometimes skin doesn’t always heal as we hope, and scarring, loss of sensation or unpleasant sensation can be a lifelong result. Sometimes changes in the skin of the genitalia can make a woman more susceptible to infections, which can cause everything from difficulty urinating to an infection that spreads throughout the body. Scarring can cause intercourse to become painful and since that is the opposite of what was expected, some woman may even progress to post-traumatic stress disorder symptoms in regard to both the surgery and the thought of sex.

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