Why is vaginal laser treatment not routine after childbirth ?
The vagina and perineum naturally change after childbirth, and some of these changes improve spontaneously during the postpartum period.
After vaginal delivery, the tissues have been stretched and may be tender or swollen. A tear or episiotomy also requires healing time.
The pelvic floor may have been stretched during pregnancy and childbirth. Its recovery continues after birth and does not depend solely on the condition of the vaginal mucosa.
Performing laser treatment simply because a woman has just given birth is therefore not justified : it must first be established whether discomfort persists and which structure is responsible.
When can vaginal laser treatment be considered after childbirth ?
Vaginal laser treatment may be considered after postpartum healing is complete, only if a symptom persists and a specific indication has been identified.
Postpartum bleeding must have ended and any tears, sutures or episiotomy scars must have healed completely. Infection, unexplained pain or a childbirth-related complication must also be ruled out before treatment.
There is no single waiting period after childbirth for vaginal laser treatment. Treatment timing depends on the mode of delivery, healing, breastfeeding and above all the nature of the symptom to be treated.
If dryness, pain, a sensation of laxity or other discomfort persists after postpartum recovery, its cause must first be investigated. Laser treatment should not be scheduled routinely after childbirth.
Can vaginal laser treatment treat dryness after childbirth ?
Vaginal dryness may occur after childbirth, particularly during breastfeeding, but does not automatically justify a laser session.
During breastfeeding, oestrogen levels may remain low. The vaginal mucosa may then be drier and intercourse may become uncomfortable or painful.
This situation may be temporary and evolve with hormonal changes and reduced or discontinued breastfeeding.
Lubricants or vaginal moisturisers may, in particular, be used depending on the situation. If symptoms are significant or persist, a medical consultation investigates another cause and discusses appropriate treatments.
Postpartum dryness should therefore not routinely lead to laser treatment.
Can vaginal laser treatment correct a sensation of laxity after childbirth ?
Laser treatment may be discussed for certain sensations of vaginal laxity, but cannot correct significant pelvic floor muscle weakness or prolapse.
After childbirth, a sensation of a wider vagina may be associated with vaginal tissues, perineal muscles or both.
If the problem is mainly muscular, pelvic floor rehabilitation is more appropriate for the mechanism involved.
In the presence of prolapse, meaning descent of a pelvic organ towards the vagina, laser treatment does not put the organ back in place.
Furthermore, scientific evidence on the effectiveness of lasers for vaginal laxity remains insufficient to recommend routine use.
Can vaginal laser treatment treat urinary leakage after childbirth ?
Laser treatment is not a first-line treatment for urinary leakage appearing after childbirth.
Pregnancy and childbirth may weaken the pelvic floor and promote stress urinary incontinence, with leakage when coughing, sneezing, running or jumping.
In this situation, pelvic floor muscle rehabilitation is the first-line conservative treatment.
Vaginal laser treatment has been studied for stress urinary incontinence, but available evidence remains insufficient to recommend it as routine treatment.
Must you wait until breastfeeding ends before vaginal laser treatment ?
Breastfeeding may temporarily change the condition of the vaginal mucosa and must be considered before treatment is decided.
Declining oestrogen levels associated with breastfeeding may cause mucosal dryness and fragility. These symptoms may change as feeds decrease and then after breastfeeding stops.
This does not mean that a breastfeeding woman must routinely wait until weaning for management of her symptoms. However, the potentially temporary nature of these hormonal changes must be considered before laser treatment is contemplated.
Can laser treatment be performed after a caesarean section ?
Yes, vaginal laser treatment can be performed after a caesarean section if a specific indication is present. Having delivered by caesarean section is not a contraindication to treatment.
A caesarean section avoids the baby passing through the vagina, but does not prevent certain intimate symptoms after childbirth. Vaginal dryness may, in particular, occur during breastfeeding because of declining oestrogen levels.
However, laser treatment is not indicated simply because a woman has given birth. After a caesarean section, as after vaginal delivery, it is considered only if a symptom persists and laser treatment is appropriate for its cause.
Article written by Dr Valeria Romano
Dr Valeria Romano supports each patient with a comprehensive approach to the aesthetics of the face, body and intimate areas, and to skin and hair quality. Every treatment is based on a personalised medical assessment.
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