No matter how much "Karen" squeezed her vagina, she just couldn't get the tightness she once experienced during sex.
"I used to be able to inflict pain on my husband because I was so strong down there," says the 48-year-old teacher from Toronto. Giving birth to two kids, however, changed things. During lovemaking, she would try so hard to get a grip that it killed intimacy and sometimes gave her muscle cramps.
The lackluster sex, Karen says, contributed to the end of her marriage. She suffered for a long time in silence, feeling that something fundamental to her sensuality was ripped away from her.
Then she saw a TV talk show that addressed a surgical procedure involving the "tightening" of loose vaginal muscles. After much consideration, and a consultation with a plastic surgeon that performed the operation, she decided to go for it.
The result: Karen felt so much stronger down there that she cried the first time she had intercourse after surgery. "It restored my happiness, my soul, and my spirit."
Hundreds of women have had their vaginas resculpted in recent years, either to make the opening narrower and stronger, or to improve upon the appearance of the labia.
Some of the surgical procedures are adaptations of medical techniques used for decades to treat women with urinary stress incontinence (urine leakage because of weak muscles), or uterine prolapse (uterus drops toward or beyond the vaginal canal). After those operations were performed, some doctors say many of the women reported better sexual feeling, or greater satisfaction from their husbands.
Word of mouth, marketing efforts, plus a growing awareness of the look and feel of female genitalia has apparently contributed to the popularity of revamping the vagina.
"The little trickle of women that I had been doing for many years has turned into a flood," says Robert Stubbs, MD, the plastic surgeon that handled Karen's vaginal tightening. He estimates that last year, for the first time, the number of women who came to his Toronto clinic for genital enhancement equaled or surpassed the number of men.
Stubbs now performs two genital surgeries for men and women per week. (He cosmetically alters other body parts.) But that pales compared to the traffic that goes through the doors of the Laser Vaginal Rejuvenation Institute of Los Angeles. There, founder and director David Matlock, MD, performs 10 female genital operations a week and boasts a four-to-five month waiting list.
Although centers that perform vaginal enhancement are scattered around the U.S. and Canada, the Institute appears to be one of the most aggressive in marketing the modification of women's privates. Ads featuring a woman in apparent ecstasy -- exclaiming 'You won't believe how good sex can be!' -- have contributed to the growth of a lucrative business.
Compared to all obstetricians and gynecologists, Matlock says that his revenue is in the top one percent. And it's no wonder since each woman that lies on the operating table is asked to shell out $3,800 to $6,000 for a tailor-made vagina. Combination packages for different procedures can reach up to $15,000. (A resculpted labia at Stubbs' clinic goes for $2,300 by U.S. standards.)
The highly profitable venture is the reason, Matlock says, ob-gyn doctors have been flocking to his office for training and support. In the next few weeks alone, he will coach medical professionals from New York, Korea, and Canada, who plan to open their own regional institutes. A satellite office opened up in Atlanta earlier this year.
A Lift Down Under: Worth It?
Matlock makes no excuses for his work. He says he's merely listening to women, who for years have been dismayed when their doctors tell them to accept that loose vaginal muscles are just part of getting older or having children. Other women come in, he says, because they decide on their own that they want more aesthetically-pleasing vaginas, and often ask him to make theirs look like the models in Playboy magazine.
Many experts have frowned upon surgical methods like Matlock's, particularly because there are no recognized scientific or academic studies on the benefits or risks of the procedures.
"Surgery should be the last resort," says Alan Wabrek, MD, PhD, professor of obstetrics and gynecology at Syracuse University in New York, who also ran a sexual counseling program at Hartford Hospital in Connecticut for 20 years. "If one person or the other is unhappy with a sexual relationship, it's frankly rare that something surgical is going to solve that."
All types of surgery has its risks, he adds, and any claims otherwise are untrue. Inevitable scarring, for instance, can leave the treated area -- especially the genitals -- very tender and painful.
Wabrek recommends discussing the sexual dilemma first with your partner, noting that perhaps she may have thought he was disappointed with her performance in bed when he really wasn't.
If that doesn't work, he suggests Kegel exercises, which are scientifically proven to help women increase muscle tone, and to become more aware of the sensations coming from her vagina.
Cindy Pearson, executive director of the National Women's Health Network, agrees with Wabrek, calling marketing claims for better, more sexually sensitive vaginas "a bunch of baloney."
Although Pearson is all for bestowing more attention on women's sexual needs and desires, she says she would prefer to see less invasive and less dangerous methods. She likens some vaginal surgery to the archaic practices of removing ladies' lower ribs to reduce waistline sizes, and having women wear rings around their necks to make them look longer. She says society has always had an official-sounding explanation for the reshaping of women's bodies.
Pearson, however, is not totally opposed to vaginal enhancement procedures, saying that it may work for some women who have a medical condition that could be relieved through surgery.
Yet she says "We [at the National Women's Health Network] always warn people--when they're thinking of trying something where the benefit is not well-proven--that no side effect or complication is worth it."
The American College of Obstetrics and Gynecology has no official position on the subject. Neither do the American Medical Women's Association and the American Association of Sex Educators, Counselors, and Therapists.