Rejuvenating the Intimate Area with Filler 

Nurse practitioner Heidi Dollimore shares a case study of successfully treating genitourinary syndrome of menopause (GSM) in her 56-year-old patient

Many women suffer in silence when it comes to intimate concerns. Society has taught us to live with often debilitating conditions because ‘that’s just what happens’ as we get older.

Childbirth and menopause can have a huge impact on women’s vaginal and vulval health, significantly affecting our day-to-day life. Many women don’t know where to turn for support, with little help available on the NHS and a lack of knowledge of privately accessible treatments that could help.

Unfortunately, there’s not much positive understanding of vaginal treatments, with many stigmatising women for wanting a ‘designer vagina’.

As an aesthetic nurse with a background in women’s health, I’ve always wanted to break this taboo and help women with their intimate concerns to allow them to feel ‘normal’ again. After training with a gynaecologist, I began offering treatment a few years ago and haven’t looked back since.

Here I share my experience and a case study of successful rejuvenation…

Understanding intimate concerns

The first thing to appreciate is that most women don’t seek vaginal/vulval rejuvenation treatments purely for vanity. While they can make the intimate area look better, the main purpose of most procedures is to treat a specific concern.

This could include symptoms related to genitourinary syndrome of menopause (GSM) such as vaginal dryness, itching, burning, frequent/urgent urination, urinary tract infections, incontinence, volume loss, discomfort or bleeding during sexual intercourse, and shortening and tightening of the vaginal canal.

Women may also experience vaginal laxity, leading to a loss of sensation during sex, and a weakened pelvic floor, which can contribute to incontinence.

These concerns can all negatively impact a woman’s personal and social life. A loss of libido, inability to exercise or wear certain clothes comfortably, and fear to go out for long in case of leakage are all too common.

A personal story

A regular facial aesthetics patient I treat booked a consultation for vaginal rejuvenation after noticing a poster I had up in my clinic. At 56 years old, she had gone through menopause and was not on hormone replacement therapy (HRT).

She had numerous symptoms of GSM that included dryness, discomfort at the gym due to volume loss in her labia minora (inner lips) and a stinging sensation when she urinated. My patient was embarrassed by how she looked down below and was upset about how her sex life had been affected. While she had a supportive husband, she was struggling to regain her confidence and libido.

Upon examination, I noted that her labia minora was indeed prominent, so it was no wonder that it was causing her discomfort. I explained that this had occurred as her labia majora (outer lips) had atrophied, or shrunk, as a result of a decline in oestrogen, associated with the menopause.

I then talked my patient through potential treatment options, noting that surgery could be considered. While this is outside my scope of practice, I highlighted that I could refer her to a specialist. She decided this was outside of her budget and would rather try a non-surgical option first.

I recommended augmentation and hydration using dermal filler. After a detailed discussion of what the procedure involves, along with the potential risks, my patient decided to go ahead with treatment.

In her initial treatment session, I utilised a crosslinked hyaluronic acid-based gel aimed at rejuvenating the labia majora, which had lost volume due to vaginal atrophy. This was done to enhance volume and offer protection to the labia minora as well. Studies have shown that a significant percentage of women reported improvements in their condition for up to 12 months following this treatment. I administered a total of 6ml, evenly distributed at 3ml per side, which is typically more than the usual 2ml per side I use in most cases. This variation highlighted the extent of my patient’s specific concerns.

While it was possible to address my patient’s vaginal dryness during the same session, she opted to schedule the treatments separately, with a few weeks between them. This approach was chosen to facilitate recovery and manage the expenses involved

Both treatments took around 30 minutes each, and I numbed the area with injections of lidocaine beforehand to reduce pain.

As expected, my patient was slightly red and swollen for the next couple of days, but this soon calmed down. I advised her to use a panty liner if necessary, as the internal injections can cause some blood spotting. She was also told to avoid exercise and hot baths for a week, before she could then go back to her normal routines.

Five months on and my patient is still absolutely thrilled with her results. She says the treatments have completely revolutionised her life, making her more confident and, importantly, comfortable. I expect the results from the augmentation procedure to last approximately a year, while the hydration should remain for six to nine months before a top-up treatment is needed. Of course, this varies from patient to patient and will break down quicker in those who participate in activities such as horse riding and cycling.

Empowering women’s health

This was the first time my patient had talked to anyone about her concerns, so was really delighted to learn that there were treatments that could help. Like many, she was embarrassed by her symptoms and didn’t feel comfortable talking to even her closest family and friends.

In an age where people are so driven by image-based content, it can be difficult to promote vaginal rejuvenation treatments, as many patients don’t consent to having their before and after images used in marketing, while social media sites won’t let you share intimate photographs.

That’s why direct conversations and writing about this topic is so important. As medical professionals, we should talk openly about how normal intimate health concerns are and encourage women to seek help for anything negatively affecting their life.

We now have access to excellent products and training, enabling us to offer safe and effective treatments to women in need. And if providing vaginal/vulval procedures is not for you, then please do set up referral pathways with practitioners in your local area who can help. Let’s all work together to empower women to take control of their intimate health!

About Heidi

Heidi Dollimore is a nurse practitioner with almost 30 years of nursing experience and 15 years working within aesthetics. With a clinic based in Newcastle, she offers a wide range of injectable treatments for both men and women. Heidi is also an aesthetics trainer, focusing on developing advanced skills in injecting, anatomy and complication management for medical professionals across the UK and Ireland.