• Catherine Hansen MD, MPH

Perfect Vagina, Perfect Life?

Updated: Jan 28, 2020

"Authenticity is the daily practice of letting go of who we think we’re supposed to be and embracing who we are." – Brene Brown

There is something beautiful about age; we all know it. We admire our elders, acknowledge their wisdom, embrace their advice and learn from their mistakes. But for some reason we loathe aging ourselves. During our last Empowered Women’s Circle Women’s Retreat, the overwhelming theme was a deeper desire for authentic self-confidence. Women are up to big things, with many of us running our own businesses, most running households and everyone running in a million different directions just to keep up with their lives. And to use an aviation term, we are jettisoning fuel (in the Hansen household, ideas are often formalized with aviation and space metaphors). We are leaking energy that would be better used to bring us home safely to ground zero, launch and tend our businesses, be mindful with our loved ones and laser focus on the things that really matter in our lives. Because of the eye-opening conversations we shared during the women’s retreat, I’ve become sensitized to what I’m seeing in the medical news lately.

First, the FDA issued a warning against vaginal laser rejuvenation (including the Mona Lisa and multiple other industry providers of laser therapies). Around mid-life, all women experience a decline in estrogen, though the bladder and vagina continue requiring estrogen to stay healthy and comfortable. Laser therapy has been studied and approved for multiple uses, including surgery and removal of precancerous skin lesions. Some companies (and hence providers) extrapolate that, if laser applied to the external skin will rejuvenate the underlying layers, stimulate collagen and improve elasticity, why not inside the vagina too? With the current FDA process, once a device is “approved” it can be marketed for uses never included in the original science. Many women have benefited from laser therapies and many have, thankfully, gone unharmed, but it’s becoming obvious these lasers were never intended to help women “become their best self” as one company offers. Don’t get me wrong, I look at women’s vaginas all day long—the female body is beautiful and to be celebrated but having a “youthful” vagina does not make you a better woman. Right? If there is pain, irritation or dryness, laser should not be the “go-to” therapy. I’m happy to report there are plenty of safe, proven therapies to heal and “rejuvenate” a troublesome vagina.

Then there was the disciplining of a doctor in California for treating over 40,000 women for over thirty years with untested, compounded, bio-identical hormone therapy. Bio-identical hormones (including pellet therapy) have become all the rage and touted as the fountain of youth for women entering mid-life. (Why do we need a fountain of youth again?) And is there a difference between drinking from the fountain and putting compounds in your body that have never been tested for safety, may be harmful, and have become a major money-maker for providers? It not only makes me angry, it makes me very sad. If you’d like to know more about proven, evidence-based bio-identical hormones to treat the symptoms of menopause, we share plenty of resources in our Circle or visit Menopause.org (the official website of the North American Menopause Society).

Finally, I was struck by this headline, The Quest for the Perfect Vagina: What You Should Know about Cosmetic Genital Procedures (ref 2). A perfect vagina? Unless you’re a gynecologist and examine vaginas for a living, how exactly does one define the “perfect” vagina? In my practice, I’ve discovered women are often misled by mainstream media, their friends and, sadly, their male partners into believing something is wrong with them. When he says, “It doesn’t feel like my last girlfriend, it’s not tight enough,” a young woman may willingly go under the knife on an endless quest to please. There are reasons a vagina may need surgery, but when the biggest reason is another person’s opinion—or a photograph in Penthouse magazine—we should seriously re-evaluate the messages we’re receiving.

If you have decided to follow one of these paths, there is no shame in that. Many women have and will. And assuming you’ve made the decision for reasons true to your core, you have disposable income and your health is good, you should continue on the path that feels right to you (under the care of a reputable healthcare provider who knows the meaning of “informed consent”). But for most of the women I see, nurturing a deeper connection to authentic self-confidence would lead to a healthy indifference toward the expectations of others and a re-alignment of their precious human resources.

In a world where “I am enough,” many of these therapies would not exist.

Women want to feel fit, vital, healthy and alive.

Women yearn for presence and joy in their lives.

Women desire vitality and well-being.

Yet, we exhaust our time and money because we’re made to believe that all of that comes in the form of a cream, a device or a surgery. It doesn’t.

But the good news is, it’s totally possible to look, feel and be your best at any age. It’s time to re-define what “best” means from information that is within you and not from what you read on social media, hear from your friends or examine in the mirror when you’re crying on the bathroom floor. (Yes, many of us have experienced those times when the bathroom floor is the safest place to shed our tears!)

Just think about it: Our vaginas are sacred. First and foremost, they define our femininity and bring us personal pleasure; we use them to share love in very intimate and powerful ways; they lead to the creation of another human being; and they deliver the miracle of life. These truths about women remain remarkable to me despite thirty years of studying the science of reproduction.

Being feminine is something to be cherished, revered and wildly celebrated. Bringing authenticity to our role as women—with wisdom, resources, life experience, capacity and confidence—is our ongoing, personal quest. It’s time to search for authentic relationships, authentic confidence and authentic power so we can rise up and help other women lean into an authentically loving relationship with themselves.

We can’t do it alone.

Let’s call it the “Quest for Imperfect Authenticity.” Now that’s a worthy headline for a news story!

Dr. Hansen's eBook: Meaningful Menopause available HERE.

Women's Health Resources available from the Empowered Women's Circle.


1. One (of many) Articles about Dr. Hall: http://www.latimes.com/business/la-fi-doctor-hormones-disciplined-20180912-story.html. Accessed Sept 22, 2018.

2. FDA Warning about Laser Devices for ‘Vaginal Rejuvenation’. https://www.medscape.com/viewarticle/900023. Accessed Sept 22, 2018

3. Video Series, Coffee with Catherine, available at https://www.ewcircle.com/membershipvideos Posted Sept 14, 2019.

4. The Quest for the Perfect Vagina: What you Should Know about Cosmetic Genital Procedures. https://www.medscape.com/viewarticle/901013?src=WNL_infoc_180922_MSCPEDIT_obgy&uac=178850CG&impID=1742821&faf=1#vp_3 Accessed Sept 22, 2018.

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