Everywhere you look, women seem to be shrinking.
Mounjaro, Ozempic and Wegovy – once the preserve of people with chronic medical conditions or celebrities with connections – are weight loss drugs that are now increasingly easy to come by and are even planned to be rolled out to at least 1.6 million people in the UK over the next 12 years.
The risks associated with weight loss medications are still being debated by medical professionals, but one known area of concern is muscle loss – a recent study found that 25% of people taking Mounjaro experience loss of lean muscle mass. Much has been written about the so-called 'Ozempic face' – a loss of volume and tone in the face caused by rapid weight loss. But it's not just your face which might be impacted – it transpires that the rest of your body, specifically your vulva, might also reflect the Ozempic effect.
‘Ozempic vagina’ might sound like yet another made-up condition intended to make women worry about their bodies (as if we needed any more of those), but depressingly there is an element of truth to the concept. According to consultant gynaecologist Anne Henderson, a spokesperson for NAYDAYA, vaginal weight loss is actually a potential side effect of GLP-1 injections. “Yes, this is a potentially huge issue here, unless the injections are accompanied by a high-protein diet plus strength training," she says. "Muscle loss or sarcopenia is definitely a possibility.”
“It becomes like an old, overused rubber band.”
Kate, 31*, from London, is using Mounjaro, a weight loss medication comparable to Ozempic or Wegovy. “I was one of the first few thousand people to get the jab,” she tells me. “I’d had a few health issues through my twenties and my weight was very high, especially for my five foot height.” Kate lost a significant amount of weight, very quickly. “I lost 68lb in 26 weeks,” she tells me. “That's what I was hoping to achieve, so I was happy. But I would be lying if I said it didn’t have an impact on my body. I feel totally different to the touch – my skin feels slack and my muscle tone feels non-existent, which admittedly I could maybe change if I worked out more, but I started the weight loss medication in part because I don’t have time to work out.”
I ask Kate whether this change includes her vagina. “Yes,” she tells me. “When I say my whole body feels different, I mean my whole body feels different. The best comparison I can think of is after I’d had a baby and fully recovered, like there isn’t something wrong per se, but it feels different. And I haven’t looked, but I guess it probably looks different, too.”
The most straightforward way to avoid losing vaginal tone from weight loss would be to skip the weight loss jabs, but for a variety of reasons – from health concerns to the eternal pressure for women to make their bodies as small as possible – hundreds of thousands of women are opting for the medication, and in doing so have become a potential audience for expensive, painful and potentially dangerous medical procedures.
I was prescribed Wegovy and Orlistat online with few checks.
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Enter: labia puffing. A procedure that injects filler or transfers fat into the labia. Why? According to the Centre for Surgery, an aesthetic surgery based in London: “Labia puffing addresses these concerns by restoring the plumpness of the labia, thereby contributing to a more aesthetically pleasing and youthful appearance.”
While the words “injection into the labia” are enough to make some people want to glue their knees together, the procedure is increasingly popular. You'll find a surge of UK clinics offering the treatment via one quick Google. But is there any benefit to the process, or is it just another way to convert body insecurity into cold hard cash?
I spoke to Dr Penny Law, who is a consultant OBGYN and vaginal health expert for Luna Daily. She explained that the only time there’s a medical application for a filler or fat transfer to the vagina is in cases of vaginal atrophy. “There's no medical reason to use fillers or a fat transfer vaginally,” she says. “Unless you've got vaginal atrophy, and in that case, you would be doing so in order to minimise the possible effects, which will include soreness and potentially urinary tract infections. Vaginal atrophy generally impacts much older women, unless a person had experienced an early menopause.”
Unsurprisingly, there are plenty of risks attached to labia puffing, which include a reaction to the filler and vascular and nerve damage, which can result in long-term pain. Plus, if you are worried about the way your vulva looks, you should bear in mind that one of the listed risks of the process is “uneven cosmetic appearance due to filler migration or erratic absorption”.
I asked Dr Penny whether she’d recommend labia puffing to women who do not have vaginal atrophy. Her initial reply is one word: “No.” She then went on to explain that there is no benefit to the process for women who do not have atrophy. “This procedure is a result of the porn industry encouraging women to believe they should have ‘perfect’ genitals,” she says.
Choosing to have the fat sucked out of your cheeks is not an inherently empowering decision.
Dr Penny is obviously right. But feeling self-conscious about your vagina (however illogical) is common. A University of Melbourne study found that girls as young as 13 were already worried about how their vaginas look. So while we shouldn’t need to change our bodies to feel attractive, we all know that women worldwide have done, and will do.
Leah Levi is a psychologist and sexpert at Flure. I asked her about the sticky situation many women find themselves in, where their vulva is a source of shame and is impacting their sex life.
“There’s no proven evidence that having a ‘perfect’ vulva enhances sexual satisfaction for the person or their partner. In fact, procedures like labia puffing carry risks, including infection, scarring, and potential loss of sensitivity in an area crucial for sexual pleasure. Sensitivity in the vulva and labia is a key component of sexual enjoyment, and any alteration that reduces this can detract from sexual experiences rather than improve them. True sexual satisfaction comes from communication, confidence, and emotional connection, rather than conforming to an aesthetic ideal.”
She goes on to explain that there are plenty of other things you can try before you spend thousands of pounds on vaginal injections. “If someone feels that sex is not enjoyable because they dislike the appearance of their genitals, the best approach is to focus on building self-acceptance and addressing body image concerns. Therapy can be incredibly helpful, particularly with a specialist in body image or sexual health, as it allows individuals to explore and challenge the insecurities that may be holding them back.”
A better understanding of how vulvas are ‘supposed’ to look (spoiler, there’s no right way) might also be helpful. Leah suggests: “Learning about the natural diversity of vulvas can normalise differences and help dismantle unrealistic standards perpetuated by the media.
“Practices like vulva-gazing workshops can foster a deeper connection with one’s body and encourage appreciation for its uniqueness. Educating oneself about the vulva’s functionality and its role in pleasure can shift the focus from appearance to the experiences it enables.”
All of that said, it's your body, your choice. If the appearance or muscle tone of your vagina is making you unhappy, there are options to explore. I asked Dr Anne Henderson, whether there is anything you can do directly to your vagina, other than puffing.
She explained: “I would recommend the use of something longer term and more targeted such as radiofrequency treatments which have a proven track record in facial aesthetics and have been subject to trials and studies as well. I use the Inmode Empower device which has specially designed tips for the genital area, both externally and internally. This treatment helps to promote collagen and elastin formation which gives a longer term result than fillers.
“I also recommend the use of a high-quality lubricant or moisturiser which helps promote a healthy skin barrier, softness, and resilience.”
Ultimately, your vulva is your business and your business alone, but the experts seem to be in enthusiastic agreement that there are a lot of better options for your vulval health than injecting it with hyaluronic acid, or transferring fat. If you are determined to access cosmetic vaginal treatments, though, make sure only ever to visit a fully licensed cosmetic therapist. The NHS has this helpful guide to finding the appropriate person to perform a procedure.
*Names have been changed.
As a beauty editor, I can't endorse the ‘Barbie Botox' trend.
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