[2] Consequences may include experiencing sexual dysfunction, ranging from dyspareunia (i.e. painful intercourse), increased vaginal “wind” to overactive bladder (OAB).

[3] Outcomes following these treatments are generally positive, with reported significant and sustainable long-term effectiveness and improved sexual life quality.

[5] Risks of microtears and vaginal tissue trauma may therefore increase significantly during sexual intercourse, resulting in pain, the feeling of burning and even injuries.

[6] VIL may also lead to weakened pelvic floor muscles and cause improper closure of the vaginal introital, allowing easier entering of air into the vagina.

[7] Vaginal introital laxity may also weaken the support structures around the urethra, which is the tube that helps carry urine outside of the body from the bladder.

[8] During childbirth, a huge pressure may be exerted onto the vaginal tissues during the passing of the baby through the birth canal, especially onto the introitus, causing laxity.

[7] During menopause, the significant decline of estrogen and progesterone levels may cause reduced production of collagen and elastin, leading to thinner and less rigid vaginal walls.

[7] The weakening of pelvic floor muscles due to these sudden hormonal changes is also a contributing factor to potential vaginal introital laxity.

[7] Diagnosis of vaginal introital laxity involves a comprehensive evaluation of the patient's symptoms and medical history, which may include physical examination and response to several validated questionnaires.

[9] Since vaginal introital laxity is usually a patient self-reported condition based on subjective perceptions, there are no objective measurements to quantify its severity.

[12] Next, inspection of external genitalia, including the labia majora and minora, clitoris, perihymenal tissue (vestibule), hymen, posterior fourchette, vagina, and cervix will proceed.

[15] This may involve requesting patients to perform specific movements, such as contracting and relaxing the pelvic floor muscles, coughing, or bearing down.

[20] The former renders collagen- and elastin-fibre remodelling by denaturing the tissue, while the latter has a deeper secondary thermal effect and controlled heating of the target mucous membrane of the vaginal wall due to a higher affinity of water absorption.

[22] With the treatment biophysics, the operator can significantly lower the amount of energy administered by defining the target vulvar area's volume and depth.