Sis Vajayjay: As luck would have it, not every woman has a G-Spot. While studies indicate that approximately 40% of the female population never found out where their G-Spot is, 15-20% of these women either do not have a G-Spot or have one that is desensitized. It is a pity for women who are lucky enough to have a G-Spot, but it is so desensitized that it might as well be non-existent. The problem may be caused by vaginal laxity after childbirth. Other possible factors include psychological issues, coital positions, partner's skills and size. If vaginal laxity is to blame, then it may be beneficial to undergo non-invasive vaginal rejuvenation to thicken the mucous tissue and tighten the vagina. In addition to that, injecting hyaluronic acid fillers into the G-Spot may also help to enhance its sensitivity and thus sexual pleasure. Results typically last from 6-12 months.

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Sis Vajayjay: The orgasmic pleasure from G-Spot stimulation is truly more intense and enduring than of a clitoral orgasm. The fabled G-Spot was first discovered by a gynaecologist Ernst Gräfenberg, hence the name G-Spot. The size, exact location and sensitivity vary from one individual to another. Its most likely location is between the 11 o'clock to 1 o'clock position on the anterior wall, 5cm from the introitus. It feels like a rough patch the size of a pea. The G-Spot will swell up when aroused, making it easier to locate. 

Sis Vajayjay: The following vaginal discomforts may signal more serious health problems!

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1. #not all vaginal discharge is the same - In general, you may notice an increase in vaginal discharge during lactation and ovulation. Vaginal discharge is normal when it is clear or milky in colour, and does not have an unpleasant odour. Vaginal discharge that is yellow or greyish in colour, has a thick or clumpy appearance, and/or an overt malodour may indicate vaginal infection. You should consult a medical practitioner for treatment.

2. #bloody discharge – If you notice pink, bloody, or brown discharge, and/or abnormal spotting in between menstruation, you should see a doctor and have it checked to rule out possibilities of cervical cancer, endometrial cancer, ectopic pregnancy, early stage of pregnancy, or simply minor injuries caused by sexual intercourse.

3. #vaginal odour – A pungent vaginal odour may be caused by the consumption of spicy foods, such as curry, onions, garlic, etc. However, a fishy or foul odour may indicate bacterial vaginitis or sexually transmitted diseases.

4. #vaginal itching – Excessive vaginal itching may signal trichomoniasis, pubic lice, bacterial vaginitis, candida infection, or hormonal imbalance.

5. #vaginal dryness – It is usually caused by hormonal imbalance induced by stress, pregnancy, or menopause.

6. #pain during intercourse – The problem may be physiological or psychological. Bacteria or fungal infections, sexually transmitted diseases, or injury may all cause discomfort during intercourse. On the other hand, psychological issues such as sexual adversion disorder, vaginal convulsion, or other psychological factors may also be the cause of painful sex.

Sis Vajayjay: In addition to treating stress incontinence, Vaginal Rejuvenation Treatments also help to rejuvenate and tighten the vulvovaginal areas. As with facial skincare, we would not withhold treatment until aging makes its full impact on our facial skin. Instead, we give our facial skin daily care and regular maintenance to defy the effect of aging. The same principal applies to our Lady Gardens. Why would we want to withhold treatment until problems of vaginal laxity and urinary incontinence set in? It is always preferable to deal with the problems in their early stage to avoid deterioration. Treatment options include:

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Vaginal Tightening Treatment – This radiofrequency treatment promotes new vaginal collagen tissue growth.  A 30-minute treatment session once every 12 months helps to restore youthful tautness and elasticity. It revives clitoral sensitivity to enhance sexual pleasure.

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Vaginal Treatment – A sterilized applicator is inserted into the vagina canal to deliver fractional CO2 laser onto the vaginal walls to rejuvenate atrophic vaginal mucosa. The treatment stimulates collagen tissue growth, resulting in thickening of the mucous lining, vaginal secretion and health are thus restored.

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Vulva Treatment – A powerful device delivers radio frequency and ultrasound energy simultaneously to stimulate fibroblasts in the treatment area. The treatment effectively rejuvenates and tightens the vulva skin tissue, resulting in a smoother appearance.

Sis Vajayjay: Depending on the treatment device used, exact treatment time required differs from one device to another. Generally, the time required for one treatment session is approximately 30 minutes, while some treatments may be completed in as little as 5 to 10 minutes. If the treatment room is equipped with LED display facilities, the patient would be able to view and observe the conditions of her own vagina and cervix through the colposcopy probe. For most women, this may be their very first intimate encounter with their vajayjay after all these years!

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It is important to note that prior to the treatment, your doctor will conduct a basic pelvic examination and laboratory tests, including PAP test, blood tests, urine tests, and STD tests to assess if the patient is a suitable candidate for the treatment.

Sis Vajayjay: For hygiene reasons, some women resort to vaginal douching, which is entirely unnecessary.  Douching can interfere with the vagina's pH levels, reducing the acidity and disrupting a healthy vaginal biome - the bacterial makeup of your vagina that protects it from infections. As the cervical mucus exists to prevent foreign objects from entering the uterus, regular cleansing of the labia is sufficient for maintaining proper hygiene. There is no need to use harsh cleansers or specialized cleansers, as they may destroy vaginal lactobacillus flora and disrupt the healthy vaginal biome, making the vulvovaginal area more vulnerable to bacterial infections. 

Sis Vajayjay: There is a lot of buzz about "Menstrual Cups" in recent years, especially in North American and European countries. This little rubbery thing holds the hopeful promise that Aunt Fanny will cease to be a hindrance to our daily activities.

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Menstrual cups are made of silicone or latex rubber. They come in different shapes, although most resemble the shape of a funnel. Just before your period begins, tightly fold the menstrual cup and insert it into your vagina close to the cervix. The cup will spring open and rest against the walls of your vagina, wrapping itself around the cervix to “collect” the blood, as opposed to “absorbing” it like a tampon or sanitary napkin would. The cup can be removed easily by lightly pinching the base of the cup into a C-shape to release the seal. Do not attempt pull the cup out by force! Simply empty the cup and wash it with soap and water, then reinsert it. At the end of your cycle, you can sterilize the cup in boiling water or wipe clean with rubbing alcohol or iodine. Some types are disposable, but most are reusable. A reusable cup can last up to 10 years; it is truly an environmentally-friendly product!

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To avoid Toxic Shock Syndrome, it is important to remember that you should not leave a menstrual cup in your vagina for more than 12 hours. A menstrual cup can hold about 30ml of liquid, roughly 3 times the amount a sanitary napkin or tampon can hold. However, on heavy flow days, the cup still needs to be emptied few times a day to avoid leaks. Whether this product would be adopted by the female population in Hong Kong is debatable though.

Sis Vajayjay: You might experience vaginal dryness in the initial weeks after the treatment. This is similar the situation with facial treatments – after a laser or radiofrequency treatment, your skin will be slightly dryer than normal. The condition will be back to normal within a week or two. Other than that, this treatment is relatively low-risk when it is performed by a doctor who is experienced in vulvovaginal rejuvenation treatments. In fact, the treatment is considerably more pleasant than the annual gynaecological examination!

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Much of the risks of the treatment arise from negligent sterilization procedures, improper operation of the device, or a lack of appropriate after-care. There have been worrisome stories of beauty salons providing this kind of treatments conducted by beauticians or therapists.

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Vulvovaginal rejuvenation is achieved through the application of laser and/or radiofrequency energy to stimulate the collagen tissue and vaginal mucosa in the treatment area. The machines utilized for this type of treatments are high-energy medical devices that must be operated by qualified medical professionals. When improperly used, these devices could do significant damage, such as laser burnt, tissue damage caused by overheating, or injury to the urethral diaphragm (or perineal membrane?) resulting in fistula. Conversely, the desired treatment result cannot be achieved if the energy setting is too low. An experienced medical professional would assess the patient’s individual condition and devise a personalised treatment plan based on his/her experience and professional judgement.

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In addition, sterilization of the device, tools, and applicators must be performed rigorously without exception. Patients diagnosed with vaginal candidiasis, genital warts, STD, and/or other genital infections should not undergo vulvovaginal rejuvenation treatments. Please seek medical advice to assess the risks and benefits before committing to such treatments.

One of the main causes of uterine prolapse is repeated vaginal deliveries. In the past, it was common for women to have 6 to 8 childbirths, mostly through vaginal deliveries. Uterine prolapse occurs when the pelvic floor muscles and ligaments stretch and weaken and no longer provide sufficient support for the uterus. As part of the vaginal lining becomes displaced, the uterus slips down into or protrudes out of the vagina. When the exposed vaginal tissues rub against clothing, it may lead to bleeding, sores, and even infections.

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Although this bothersome problem can be corrected through surgery, but for elderly women, there are significant risks involved. For this reason, vaginal pessaries became a popular non-surgical treatment option. A vaginal pessary is a plastic or rubber ring inserted into the vagina to support the bulging tissues. A pessary must be removed every few months for cleaning to avoid vaginal ulcers or infections. As such, it is not uncommon to see elderly ladies with their canes, wheelchairs, and/or their caretakers lining outside clinics that specialize in this kind of service.

Sis Vajayjay: Nearly all women are concerned with the sagging of their facial skin or their breasts, but they tend to neglect the fact that the uterus might also “sag” with age. Normally, the uterus sits within the pelvic cavity of the torso, supported by the pelvic floor muscles and the corresponding ligaments.  As we age, the pelvic floor muscles and ligaments weaken and no longer provide enough support for the uterus. In severe cases, the uterus slips down into or protrudes out of the vagina, leading to bleeding, sores/ulcers, or infections as the exposed tissues rub repeatedly against underwear. While it is convenient to blame the force of gravity, it is not the sole cause of uterine prolapse. In fact, multiple pregnancies, pregnancies with twins/triplets/large babies, vaginal deliveries, wounds from childbirth, advancing age, menopause, other pelvic trauma or diseases may all contribute to increased risks of uterine prolapse.

Sis Vajayjay: There are a number of different treatments in the market targeting vulvovaginal rejuvenation. The first of its kind utilises fractional CO2 laser energy to achieve vulvovaginal rejuvenation; it was a ground-breaking invention to adapt technologies previously reserved for skin rejuvenation to non-invasive vulvovaginal rejuvenation. Similar treatments using other forms of energy soon followed.  Examples include treatments using Radiofrequency (RF), Fractional Erbium YAG (Er:YAG), High Intensity Focused Ultrasound (HIFU), et cetera. Depending on the type of energy, device, and the treatment protocol, these treatments can vary widely in terms of treatment frequency, indications and contra-indications. While some of these treatments target vaginal laxity, others focus on strengthening the vaginal lining, or correcting problems of stress incontinence. To ensure it is the right treatment for you, it is very important to seek professional opinions from your doctors prior to treatment. Questions to ask your doctor include:

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1. Am I a right candidate for vulvovaginal rejuvenation treatment?

2. What are the treatment options for my specific problem(s)?

3. What pre- and post-treatment sterilization procedures are in place?

4. What are the risks involved?

5. Does sufficient clinical evidence exist to prove the treatment efficacy?

Sis Vajayjay: These symptoms are common amongst women with vaginal tissues that have been weakened by chemotherapy treatments, or amongst menopausal women experiencing a gradual loss of estrogen. In younger women who are otherwise healthy, the problem might be inherent. According to a study*, approximately 80% of menopausal women suffer from Vaginal Atrophy – thinning of the vaginal mucosa lining and loss of volume in the vulva area. When the vaginal walls become thinner, the vagina loses elasticity and moisture, making the region more vulnerable to irritations and infections.

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Clinical studies have shown that Vulvovaginal Rejuvenation Treatments are effective in treating Vaginal Atrophy. Vulvovaginal rejuvenation is achieved through the application of fragmented laser energy on the vaginal walls to create controlled, micro-injuries, spurring fibroblast and production of new tissues on the mucosa lining. As a result, the vaginal walls thicken and vaginal secretion is restored.

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* Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society

Sis Vajayjay: The darkening of labia skin tone is often assumed to be the result of too much sex, or even promiscuity. While there is some truth that the repetitive friction from sex might cause surface pigmentation, and hence the darkening of the labia skin tone, but the same repetitive friction can come from other sources, such as wearing tight jeans! Engaging in frequent sexual activities is not the sole cause of the darkening of labia skin tone, other causes include:

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1. Genetics – Like the skin tone on other parts of our body, it is genetically predetermined. Some people are simply born with darker labia. Of course, our health and physical condition may also play a role.

2. Female hormones – Female hormones affect the labia skin tone too. The hormonal change caused by pregnancy or oral contraceptives may cause skin pigmentation, thus darkening of the labia. The severity varies between individuals.

3. Vaginal infections – Chronic infections in the vaginal area can also cause skin pigmentation and the labia to darken.

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As such, our intimate parts can darken due to a wide range of reasons beyond sex. 

Sis Vajayjay: It is true that our intimate parts age as we age. Causes of vaginal laxity include:

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1. Age – As we age, the ovarian functions and the production of estrogen gradually decline. As a result, the vaginal walls lose volume and flexibility; secretions also reduce causing vaginal dryness.

2. Sexual age – Whether it is from having a colourful sexual past, too much sex too frequently, or a palate for certain sex positions or toys to spice things up, women above the age of 30 may experience a certain degree of vaginal laxity.

3. Pregnancy & Vaginal Delivery – During pregnancy, the pelvic floor muscles and ligaments are under tremendous pressure, resulting in stretch and tear of the ligaments and fascia. Wounds and traumas during labour, pregnancy with multiples, vaginal deliveries, and/or other traumas to the vaginal area may all lead to vaginal laxity.

4. Other Reasons – Remaining in the standing position for prolonged periods of time, lifting heavy objects, and other strenuous activities that levy chronic pressure onto the abdominal areas may lead to vaginal sagging (prolapse).

Sis Vajayjay: It has been reported that Hollywood actress Emma Watsons tends to her pubic hair with haircare products specially developed for this purpose! This is definitely a sign that regular care and maintenance for the Lady Garden is finally gaining momentum.

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A healthy vagina is dominated by lactobacillus flora and other gram-negative anaerobes. These strains of flora produce antimicrobial properties that break down glucose into lactic acids, thus maintaining the vaginal biome at pH≤4.5 (range 3.8～4.4). This slightly acidic vaginal biome forms a natural barrier that protects the vulvovaginal area against urogenital infections. Vaginal douching, strong alkaline soaps, and/or harsh cleansers may disrupt this delicate, self-regulating microbial balance, making the vulvovaginal area more vulnerable to bacterial infections.

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As for giving your pubic hair a little bit extras, like what Emma Watson does, the additional TLC will certainly help to keep the hair soft and glossy. To ensure that you are not subjecting your Lady Garden to harmful substances, it is best to use pure natural oils for your hair down there.

Sis Vajayjay: I can see your concern here; it can be really annoying. Sometimes, vaginal secretions carry a slightly acidic smell. This is very normal given the fact that the healthy vaginal biome is slightly acidic (pH 3.8～4.4), which forms a natural barrier against bacterial infections. Frequent bathing may not be effective in removing the smell. The trapped moisture in the labia majora and minora, combined with the trapped sweat from all the sweat glands under the pubic hair may all contribute to this unique, musky scent of the nether regions.

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One of the ways to solve this problem is hair removal. Theoretically, removing the pubic hair should minimize the amount of trapped moisture in the area, hence the smell. Some women also find that having the pubic hair removed makes menstruation less messy and uncomfortable.