Dr. Reed Provides Expert Care for Vaginal Dryness, Vulvar Itching, Painful Intercourse, Lichen Sclerosus, Labial Discomfort & Tissue Health Concerns

Many women adjust to discomfort for years before bringing it up. The shift is often slow — clothing starts to irritate, exercise becomes painful, sex stops feeling comfortable, or a familiar itch returns and won’t resolve. The cause may be structural (excess labial tissue, post-childbirth changes), hormonal (vaginal atrophy after menopause), or dermatologic (Lichen Sclerosus and related skin conditions).

Patterns Dr. Reed sees regularly include:

• Chronic vulvar itching, burning, or skin changes
• Painful intercourse (dyspareunia)
• Vaginal dryness or thinning tissue
• Chafing, pulling, or irritation from the labia minora during exercise or in fitted clothing
• White patches, fissures, or scarring of the vulvar skin

A focused exam and history come first. From there, treatment is matched to the underlying cause, not simply the symptom alone.

Treatments for Vulvar and Vaginal Discomfort

The right path depends on whether the cause is dermatologic, hormonal, or structural. The following options can be used alone or in combination.

Lichen Sclerosus Care

Lichen Sclerosus is a chronic inflammatory skin condition of the vulvar and perianal area. It causes intense itching, pain, white thinning patches that can resemble cigarette paper, and — over time — scarring of the labia minora and narrowing of the vaginal opening. Roughly 1 in 70 women are affected.

A definitive diagnosis requires a biopsy taken before any treatment begins. First-line care is the application of an ultra-potent topical corticosteroid, such as clobetasol propionate, with regular follow-up to monitor response. Adjunctive options — fractional CO₂ laser, radiofrequency, and carboxytherapy — are considered for patients who do not respond fully to topical care.

Lichen Sclerosus also carries a 4–6% risk of vulvar carcinoma, which makes ongoing surveillance an integral part of Lichen Sclerosus treatment.

Best for: chronic itching, burning, white skin changes, or known or suspected Lichen Sclerosus.

Labiaplasty for Discomfort

When the labia minora are enlarged or asymmetric, the result is often physical chafing during exercise, pulling during intercourse, visible bulging in fitted clothing, or difficulty maintaining hygiene. Labiaplasty for discomfort reshapes the labia minora to relieve these symptoms.

The procedure is typically performed under local anesthesia with optional sedation, takes one to two hours, and is done as same-day surgery. Patients return to light activity within a few days and avoid sexual activity and strenuous exercise for about six weeks.

Best for: chafing, pulling, irritation, or hygiene difficulty linked to redundant labial tissue.

Labia Majoraplasty

The labia majora — the outer lips of the vulva — can lose volume, stretch, or sag with age, after childbirth, or following significant weight loss. Excess or lax tissue often causes bulkiness in fitted clothing, chafing during exercise, and irritation during intimacy.

Labia majoraplasty reshapes the outer labia by removing a vertical, teardrop-shaped portion of redundant skin and re-approximating the edges with fine sutures. Dr. Reed performs the procedure under local anesthesia with oral sedation as same-day surgery. Most patients take five to seven days off work, resume light activity after one week, and avoid tampons and sexual activity for four to six weeks.

The technique preserves natural contours and produces a smoother, more symmetric result without large external incisions.

Best for: bulkiness, sagging, chafing, or irritation linked to excess labia majora tissue.

FemiLift & ThermiVa®

Vaginal dryness, thinning tissue, and pain during intercourse are common after menopause, after breast cancer treatment, or as a result of natural aging. Both FemiLift and ThermiVa are non-surgical options that address these changes by stimulating collagen and elastin in the vulvar and vaginal tissues.

FemiLift uses fractional CO₂ laser energy delivered through a vaginal probe. The 15-minute in-office procedure is part of a three-treatment course over 12 weeks, with results lasting up to 12 months. It is well-suited to vaginal atrophy and the dryness that follows hormonal change.

ThermiVa uses controlled radiofrequency energy applied externally and internally, with no incisions and no downtime. A standard course consists of three sessions spaced four to six weeks apart, with results lasting up to 12 months.

Both are appropriate options for vaginal dryness relief and mild stress incontinence. Dr. Reed will recommend the one that best fits your tissue, symptoms, and timeline.

Best for: vaginal dryness, painful intercourse, thinning tissue, mild stress incontinence, post-menopausal symptoms.

Pro-Nox™ for In-Office Comfort

Some of the in-office procedures above can feel intimidating, and pain or anxiety should not be a barrier to care. Pro-Nox is a patient-controlled 50/50 mix of nitrous oxide and oxygen that provides fast-acting relief from procedural discomfort and anxiety. It is FDA-cleared, self-administered via a disposable mouthpiece, and wears off within minutes.

Pro-Nox is offered alongside many of our office-based procedures, including labiaplasty, labia majoraplasty, perineoplasty, and labia puffing.

Anal Skin Tag Removal

Anal skin tags are benign growths that form around the anal opening, often after pregnancy, chronic constipation or diarrhea, hemorrhoids, heavy lifting, or strenuous exercise. They can cause itching, friction, and difficulty with hygiene, and many patients also find them a source of self-consciousness.

Anal skin tag removal is a minimally invasive outpatient procedure performed under local anesthesia. Dr. Reed excises each tag using radiofrequency, which limits bleeding, scarring, and post-procedural discomfort. Most patients return to regular activities the next day but should avoid constipation and strenuous exercise during the first week. Full healing takes about six weeks.

If hemorrhoids or other rectal findings are noted during the exam, a referral to a colorectal specialist may be recommended before treatment.

Best for: irritation, itching, or hygiene difficulty caused by perianal skin tags.