Vaginal laxity is an increasingly recognised aspect of female sexual dysfunction and pelvic health. Despite being commonly experienced, it is often under-discussed and under-recognised in clinical care. Emerging research is helping to better define this condition and guide effective, evidence-based management strategies.
What is Vaginal Laxity?
Vaginal laxity has been defined in recent literature (Pereira et al, 2025) as the perception of excessive vaginal flaccidity. It is a subjective symptom, meaning it is based on an individual’s experience rather than a single objective measurement.
Women who experience vaginal laxity may report:
- Reduced sensation during penetration
- A feeling of vaginal “looseness”
- Decreased sexual satisfaction
In some cases, it may also include
- Changes in libido, arousal, or orgasm
- Vaginal air trapping or water trapping
How Common is Vaginal Laxity?
Vaginal laxity is a common concern, particularly following vaginal childbirth. Research suggests that up to 50% of women aged 25–45 years who have had at least one vaginal delivery report symptoms of vaginal laxity (Pereira et al, 2024).
This makes it one of the more frequently reported postnatal pelvic health concerns, yet it remains less commonly addressed than other conditions such as urinary incontinence.
What Causes Vaginal Laxity?
The causes of vaginal laxity are often multifactorial and may include a combination of:
- Pelvic floor muscle changes – including reduced strength, endurance, or coordination
- Vaginal wall changes – such as altered tissue integrity or thickness
- Neurological factors – including changes in sensory perception or nerve signaling
Certain groups may be more likely to experience these symptoms:
- Women who have had multiple births (multiparity)
- Those who have had vaginal deliveries
- Women with coexisting pelvic organ prolapse
- Individuals with connective tissue changes
- Younger women (with some evidence suggesting symptoms may lessen after menopause)
Treatment Options for Vaginal Laxity
Management options for vaginal laxity can be broadly divided into non-conservative (medical/procedural) and conservative (physiotherapy-based) approaches.
Energy-Based Therapies (Laser and Radiofrequency)
Energy-based treatments, such as vaginal laser therapy (e.g. Mona Lisa Touch) and radiofrequency therapy, have been marketed as non-surgical options to improve vaginal tissue tone and sexual function.
A systematic review (Pereira et al, 2024) reported improvements in sexual function following vaginal laser therapy. However, these treatments are not without risk. Reported adverse effects include:
- Vaginal burns
- Scarring
- Chronic pain
Due to concerns around safety and insufficient high-quality evidence, energy-based devices intended for these indications have been removed from the Australian Register of Therapeutic Goods (ARTG) as of 2025.
Careful consideration and thorough understanding of potential risks is essential when exploring these options.
Pelvic Floor Muscle Training
Pelvic floor muscle training is a first-line, conservative treatment approach with a strong safety profile.
A randomised controlled trial (Pereira et al, 2025) compared pelvic floor muscle training (12 weeks) with radiofrequency therapy. Findings included:
- Similar improvements in both groups at 30 days
- Sustained improvements in both groups at 6 months
- Significantly greater improvement in the pelvic floor muscle training group at 6 months
- Improved vaginal wall thickness in the pelvic floor muscle training group
These findings suggest that pelvic floor muscle training is at least as effective as energy-based therapies, with additional benefits and significantly fewer risks.
Transcutaneous Tibial Nerve Stimulation (TTNS)
Transcutaneous Tibial Nerve Stimulation (TTNS) is a non-invasive treatment involving electrical stimulation via sticky electrodes placed near the ankle. It targets the sacral nerve pathways (S2–S4), which are involved in pelvic floor and bladder function.
Recent research (Hady et al, 2025) compared the following, in women complaining of vaginal laxity:
- Pelvic floor muscle training alone
- Pelvic floor muscle training combined with TTNS
Both groups showed improvement in symptoms of vaginal laxity. However, the combination of pelvic floor muscle training and TTNS resulted in significantly greater improvements.
This suggests that TTNS may be a valuable adjunct to pelvic floor rehabilitation in appropriate cases.
Summary
Vaginal laxity is a common and multifactorial condition that can impact sexual function and quality of life.
While some procedural treatments such as laser and radiofrequency therapy have been explored, concerns remain regarding their safety and regulation.
Current evidence supports conservative management approaches, particularly:
- Pelvic floor muscle training
- Transcutaneous Tibial Nerve Stimulation (TTNS)
These treatments offer effective, low-risk options that can be tailored to the individual and delivered by qualified pelvic health physiotherapists.
