Ozempic vulva? What you need to know

As more people turn to GLP-1 medications to help them achieve their weight loss goals, more people are coming to realize the significant side effects of rapid weight loss, which can affect nearly every part of their bodies. From "Ozempic face" to "Ozempic body," these catchphrases describe noticeably loose, sagging skin or volume loss that can accompany rapid weight changes. But these changes can affect even some hidden areas you might not have considered. Are you ready for the newest catchphrase? "Ozempic vulva."

Ozempic vulva is a phrase being used, especially on social media, to describe how rapid weight loss affects the female genitalia. Hormone levels and other factors can affect vaginal health and appearance, as can certain medications. If you are on a GLP-1 medication and are experiencing changes in the appearance of your genitalia or physical discomfort due to skin laxity, this can be a result of sudden, significant weight loss.

Concerns about genital health shouldn't be minimized or make you feel ashamed to speak up. There are things you can do to improve comfort and appearance. One of the first places you can start your search for information and a reprieve from the discomfort caused by loose skin, volume loss and irritation is a consultation with an ASPS Member Surgeon.

What is Ozempic vulva?

The benefit of turning to GLP-1 medications for weight loss is that these drugs help control appetite, slow digestion and help patients shed stubborn fat. The problem with fat loss regimens is that you cannot choose where to shed the pounds. People have coined terms like Ozempic face to describe the hollow or sagging appearance of the face following rapid weight loss, precisely because individuals cannot control where the weight comes off.

Fat may seem to melt away, but skin and connective tissues respond more slowly and can't suddenly shrink. The result is skin that may be less elastic, appearing loose or saggy.

Rapid weight loss can cause all types of fat pads to shrink, leaving loose skin behind, including in the face and even the vulva.

"Like any area of the body, significant weight loss from GLP-1 medications – or really any form of weight loss – can cause deflation of the soft tissues, resulting in a more baggy labia majora and possibly more protrusion of the labia minora," said Karen Horton, MD, MSc, FACS. "Patients may also notice their genital region more with weight loss if it was previously hidden by significant fat in the pubic and lower abdominal region."

Not only can volume loss change the appearance of these structures, but loose skin can also cause discomfort, chaffing and irritation. These changes may also impact sexual satisfaction, confidence and even clothing choices.

"Rapid weight loss from GLP-1 medications can lead to sagging and deflation of your tissues, so in women, this can include the mons and vulva," said Katerina Gallus, MD, FACS. "This is the area over the pubic bone and the outer lips of the vagina. Laxity and fat loss can lead to extra tissue in that area, which is definitely bothersome."

Some studies also show that rapid weight loss from GLP-1 medications can lead to a decrease in lean muscle mass. Muscle weakness or loss in the pelvic floor may lead some patients to experience minor urinary incontinence or discomfort.

How do changes in the vulva affect comfort and confidence?

Cotton panties, fancy thongs, cocktail dresses, workout gear and everyday clothing – the genitals are almost always covered by something, so why would anyone be concerned with excess skin?

The fear of being disregarded may be one of the reasons that women are reluctant to talk about changes in their vulva and genitals following rapid weight loss. If it is covered most of the time, why should you be bothered by these changes? The fact is, there are plenty of reasons to be proactive about discussing intimate changes in the body with a medical professional.

"Patients can complain about the changed appearance of their vulva, loss of former fullness that is associated with youth and vitality and a general 'aged' look to many parts of their body, especially their face and also their genitals," said Dr. Horton.

It's not just appearance, but function.

"Today's activewear styles include leggings and tighter clothing," said Dr. Gallus. "My patients have complained that the extra tissue in that area bulges or sags in these garments, making them self-conscious. The same goes for swimsuits and tighter-fitting jeans. Although their weight loss may make their clothing size smaller, this can mean sticking to looser-fitting clothing. Chafing or discomfort with exercise is also an issue, especially for those who bike or run longer distances."

What you can do to restore appearance and function

There are ways patients can restore appearance and improve comfort after significant weight loss with GLP-1 medications.

"There are several procedures that can be performed either separately or in combination to address concerns in the female genital region after weight loss," said Dr. Gallus. "Noninvasive procedures, such as radiofrequency microneedling and minimally invasive tightening with radiofrequency energy, are options for those with mild laxity. Patients can also consider filling the deflated areas with either their own fat or other products, including hyaluronic acid-based and human-derived fat products."

Surgical options can help improve the appearance of the area and help reduce irritation and chaffing caused by excess skin.

"A labiaplasty can trim redundant and hanging labia minora, in particular the more darkly pigmented part of the inner lips of the vagina," said Dr. Horton. "A labia majora reduction can reduce the length of the outer lips of the vagina and tuck them inward so that they do not hang as low after massive weight loss."

Start with a consultation with an ASPS Member Surgeon who can evaluate your specific needs and concerns to narrow down the types of procedures that can help you achieve your goals.

"The gold standard is excision of the excess skin, monsplasty, where the area above the pubic bone is incised, lifted and excess tissue removed, is one popular option," said Dr. Gallus, adding that these types of surgical procedures may also be performed in conjunction with other body contouring surgeries.

For patients experiencing dryness or other vaginal issues, speak with a doctor who can help identify the root cause of reduced natural lubrication. A gentle, non-toxic lubricant may work to ease dryness. However, for perimenopausal or postmenopausal women, hormonal treatments, such as an estrogen cream, may be more effective. While surgery can help address discomfort caused by loose skin and volume loss, as well as the appearance of the genitals, don't underestimate adding strength training to your routine.

"Maintaining a strong core is important for all of us, and good pelvic floor strength goes hand-in-hand with body weight exercises or classes such as barre – my personal favorite – or Pilates," said Dr. Horton.

Lifestyle changes like incorporating body weight exercises and other forms of weight training can be even more comfortable, physically and mentally, following targeted plastic surgery treatment to address Ozempic vulva.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.