Vaginal introital laxity

Vaginal laxity is a symptom of pelvic floor dysfunction characterised by a sensation of looseness of the vagina.^{[citation needed]}

Vaginal laxity

Signs and symptoms

Pathophysiology

Diagnosis

Physical examination

Healthcare providers will perform pelvic examinations to assess the vaginal tissue.^[1] Patients are first asked to empty their bladders to improve access to the pelvic organs, and to alleviate any discomfort or pressure that may arise from a full bladder during the examination.^[1] They are then placed in a supine position, usually lying on their back on birthing chairs at 45 degrees with their feet in stirrups, allowing the legs to be comfortably positioned.^[2] This position is called the dorsal lithotomy position, which is most commonly used in genital examination.^[2] In some cases, alternative positions such as the supine frog leg position or the prone knee chest position may be used.^[3] The speculum is available in different sizes and shapes to accommodate individual anatomy.^[4]

Moreover, pelvic floor assessment may be used to evaluate the strength and tone of the muscles.^[5] This may involve requesting patients to perform specific movements, such as contracting and relaxing the pelvic floor muscles, coughing, or bearing down.^[5] This helps evaluate the muscle function and identify any issues or weaknesses.^[5]

Vaginal laxity questionnaire

A vaginal laxity questionnaire (VLQ) is designed to evaluate the degree of perceived vaginal looseness.^[6] The questionnaire covers several aspects:^[6]

• Physical symptoms: sensations of looseness, lack of tightness, or reduced friction during sexual intercourse
• Sexual function: changes in sexual satisfaction, orgasmic intensity, or sexual desire due to vaginal laxity
• Impact on quality of life: impact of vaginal laxity on self-esteem, body image, and overall well-being
• Emotional well-being: feelings of embarrassment, discomfort, or distress related to vaginal introital laxity

Sexual satisfaction questionnaire

A sexual satisfaction questionnaire (SSQ) is used to assess sexual quality of life and sexual function.^[7]

Treatment

The United States Food and Drug Administration has issued a warning against the use of energy-based (laser and radiofrequency) devices to treat vaginal laxity, as its safety and efficacy need further investigation.^[8] Laser and radiofrequency treatments do not improve sexual function,^[6] and vaginal tightening does not increase sensation.^[6] Pelvic floor muscle strength was improved after treatment.^[6]