That’s What It’s Called… Labial Atrophy?

You’re living life. Doing your thing. Trucking along, being a woman. One day, you notice something, and it catches you off guard. “Wait… when did that happen?”

As women move through life, “doing their thing,” going through hormonal changes, having children, and experiencing shifts in weight, labial atrophy tends to happen subtly over time. A common and overlooked condition, it can impact how the vulva looks, feels, and even functions, but it is treatable.

You aren’t alone, and there’s nothing “wrong.” Your body is evolving as it’s supposed to, and with subtle volume restoration, minimally invasive procedures, and surgical options available, your vulva can look and feel like a healthy, youthful part of your body again.

What is Labial Atrophy?

Labial atrophy is when the soft tissues of the vulva experience thinning, shrinking, or loss of volume in the labia – most commonly the labia majora (the outer lips). Hormonal changes, particularly drops in estrogen and androgen levels, cause skin, fat, and connective tissue that normally keep these areas plump and elastic to lose density and hydration. Over time, the tissue becomes atrophied, less cushioned, and sometimes more sensitive or dry.

That “Wait, what’s happening?” notion starts to get more attention when everyday activities feel different: clothes rubbing uncomfortably, reduced padding during exercise or intimacy, or a change in appearance. Other symptoms can include:

• Thinner or less full labia (typically outer labia)
• Increased sensitivity or discomfort
• Increased vaginal dryness or irritation
• Changes in how the vulva looks under clothing or during intimacy

They’re normal changes, but that doesn’t dim the emotional component. Even if the appearance isn’t bothersome, the dryness and irritation can make sex increasingly uncomfortable, driving a wedge into your relationships. But you don’t have to hide it or be ashamed of it.

What Causes Labial Atrophy?

A healthy vulva is a complex structure that’s made up of:

• Skin and subcutaneous fat that give the labia their volume and cushioning
• Connective tissue and collagen fibers that provide elasticity and structure
• Peptides and proteins involved in the intricate process of tissue repair
• Blood vessels that supply tissues with oxygenated blood and nutrients
• Nerves (over 8,000, to be precise) that support sensation and function
• Hormonal pathways that regulate moisture, tissue thickness, and elasticity
• Nutrients, vitamins, and minerals like vitamin C, zinc, and amino acids, are fundamental to collagen production and tissue repair

When these components are in balance, the vulva is resilient, hydrated, and fully functional. So, what throws this off? Essentially, life does!

• Hormonal changes: Drops in estrogen, progesterone, and/or testosterone, especially during perimenopause, menopause, or after surgical procedures like oophorectomy (ovary removal), reduce tissue hydration, elasticity, and collagen production.
• Aging: Collagen naturally declines as we age. That leads to thinner, less resilient skin and softer, less plump tissue.
• Childbirth and weight fluctuations: Tissue stretching, changes in fat distribution, and tissue remodeling can alter the shape and volume of the labia.
• Lifestyle factors and nutrition: Poor nutrition, dehydration, smoking, and chronic stress affect tissue repair and blood flow, contributing to cellular damage and loss of labial volume.

The lips lose their plumpness, the tissue feels less resilient, the vagina might be more sensitive or drier, and there is a biological underpinning. Once you understand what’s happening at a structural and hormonal level, it’s easier to figure out the restorative treatments available (and what not to do!).

Treatment Options

Yes, there are treatment options. Self-discovery and proactive care are increasingly accepted in women’s health, and sexual wellness is an integral part of your overall well-being.

Labial Puff

The Labial Puff procedure treats the labia majora (outer lips) that have lost volume. Patients often complain of a “deflated” appearance that’s probably due to the usual suspects: hormonal changes, childbirth, and weight fluctuations. By injecting hyaluronic acid-based dermal fillers, the labia regain volume, hydration, and a youthful appearance. The procedure takes 20–30 minutes and provides immediate, lasting results. Learn more

Scarless Labiaplasty

Scarless Labiplasty (aka FemTite at Aayla) is a minimally invasive option that tightens and refines the labia majora, labia minora, and mons area using radiofrequency energy – no cutting or incisions required. Similar to the technologies used for facial or body tightening, it restores a youthful, vibrant appearance while reinstating function. The controlled energy creates microscopic thermal stimulation within the tissue, prompting collagen remodeling and cellular turnover. As the tissue heals, it becomes stronger, more elastic, and better hydrated, supporting healthier, lubricating cells and improved overall vulvar function. Learn more

Surgical Labiaplasty

Surgical labiaplasty addresses excess, elongated, or asymmetric labial tissue, usually in the labia minora (inner lips). Women who seek this procedure often struggle with discomfort from clothing, self-consciousness, or difficulty during intimacy. Dr. Taghechian performs labiaplasty under local anesthetic with sedation, combining medical, surgical, urologic, and cosmetic expertise to achieve a natural appearance. Recovery is quick, and pain is minimal. Learn more

Vaginal Rejuvenation

While labial puff, scarless labiaplasty, and surgical labiaplasty primarily address the external vulvar tissues, vaginal rejuvenation targets the internal vaginal canal and surrounding supportive tissues, complementing labial treatments to restore elasticity, hydration, sexual comfort, and other changes associated with atrophy.

Rather than changing the appearance of the vulva, these treatments aim to restore the vaginal environment itself. Using radiofrequency and electrical muscle stimulation (EMS), rejuvenation addresses issues such as vaginal dryness, mild laxity, irritation, and discomfort during intercourse that often accompany hormonal changes or aging. Learn more

What Not To Do

Some first-line over-the-counter (OTC) treatments are legitimate and can help relieve symptoms. They won’t reverse labial atrophy or correct the underlying hormonal or structural changes, but they can take the edge off dryness, irritation, and friction while you explore longer-term options. That said, some OTC products and habits can make symptoms worse in the long run.

Avoid lubricants or topical products with fragrances, parabens, or harsh chemicals, as they can irritate sensitive, thinning tissue. Using alcohol-based cleansers, douching, or aggressive exfoliation can disrupt the vaginal flora and strip away natural moisture. The World Health Organization (WHO) has also cautioned against certain types of lubricants, particularly hyperosmolar lubricants, which draw water out of vaginal cells instead of hydrating them. Products on that list contain glycerin and propylene glycol, which, when used repeatedly, can cause microscopic tissue damage, increase irritation, and worsen dryness. Products containing nonoxynol-9, chlorhexidine, or petroleum-based ingredients (which should not be used with latex condoms) are also not recommended because they can compromise tissue integrity and increase irritation or infection risk.1-2

Switching gears to gentle, hydrating products, adequate hydration, and balanced nutrition while using appropriate lubrication can do wonders. And while it may feel counterintuitive at first, appropriate lubrication paired with gentle sexual stimulation can actually be beneficial. Increased blood flow and mechanical stimulation encourage the endothelial cells lining the vaginal tissue to function more effectively, improving tissue oxygenation, lubrication, and cellular health over time.

At Aayla, we want you to know your options. You don’t have to undergo major surgery to regain self-confidence. And you don’t have to dismiss your sex life as something to live without as you grow older.

Dr. Taghechian has years of experience with labiaplasty and advanced intimate procedures, using the latest technology to combine safety with results that look and feel natural. If you’re noticing changes and want guidance, give the team at Aayla a call. A consultation with Dr. Taghechian can unburden your anxiety, quell your fear, and set you on a path to restoring sexual wellness.

Resources:

• Women’s Voices for the Earth. (2024). Osmolality and pH Properties of Some Commercial Lubricants. Women’s Voices for the Earth. https://womensvoices.org/osmolality-ph-properties-commercial-lubricants/.
• Women’s Voices for the Earth. (2024). Are Lubricants Safe? Potential Hazards of Lubricants for Women. Women’s Voices for the Earth. https://womensvoices.org/lubricants-womens-health/.