Juliet Vaginal Rejuvenation

Many women notice intimate symptoms creeping in gradually: dryness, burning, recurrent irritation, a change in comfort during sex, and sometimes urinary symptoms such as urgency or mild leakage. These changes are common, but they are not “just something you must put up with”.

What matters is why the symptoms are happening.

Common drivers include:

• Hormone-related tissue change around peri-menopause and menopause
• Postpartum tissue recovery (in selected cases)
• Pelvic floor weakness contributing to urinary symptoms
• Irritation from products, repeated infections, or skin conditions affecting the vulval area

Because symptoms overlap, a proper assessment is essential before any laser treatment is considered.

How Juliet laser works

Juliet uses Er:YAG laser energy that is strongly absorbed by water in tissue. In practical terms, this allows controlled energy delivery to the vaginal lining and surrounding tissue with the aim of supporting tissue renewal and improving comfort. Different settings can be used depending on the clinical goal, and the endpoint is always gentle tissue response, not aggressive injury.

Important: The evidence base varies by symptom and patient group. Improvements are possible, but outcomes are not guaranteed and results vary between individuals.

What Juliet may help with

• Vaginal dryness, burning, irritation or itching linked to hormonal change
• Discomfort with intimacy where atrophy-related change is likely and other causes have been excluded
• Selected urinary symptoms such as mild stress urinary incontinence or urgency-type irritation (only where appropriate and usually alongside pelvic floor work)

If symptoms are driven by infection, significant prolapse, active vulval dermatoses, undiagnosed bleeding, or another medical problem, Juliet is not the right starting point.

When Juliet is not appropriate

We do not proceed with Juliet if any of the following are present (this list is not exhaustive):

• Pregnancy
• Active vaginal or urinary infection
• Undiagnosed vaginal bleeding
• Suspected malignancy or unexplained lesions
• Significant prolapse on examination (e.g., grade 3 cystocele) — referral is needed
• Smear history not up to date (must be within 5 years)
• Severe or uncontrolled vulval skin disease, or pain syndromes where laser may worsen symptoms

If there is diagnostic uncertainty, we prioritise medical evaluation and referral over treatment.

Am I suitable? What we assess in your consultation (30 minutes)

Your Juliet consultation is doctor-led and typically takes around 30 minutes. We focus on:

• Your symptoms (dryness, irritation, pain with sex, urinary symptoms)
• Menopause status, childbirth history and any pelvic surgery
• Hormone history (including whether you use or wish to avoid hormonal options)
• Smear screening date (must be within 3 years)
• Examination to exclude significant prolapse and check tissue health
• Whether there are signs of infection or a vulval skin condition needing different care

A chaperone is always offered.

How the procedure is performed (what to expect)

Juliet is performed as an in-clinic procedure. A typical appointment includes:

1. Preparation and comfort
   A topical anaesthetic is applied externally and left for around 20 minutes to ensure your comfort during the session.
2. Treatment
   The laser treatment is performed using a vaginal probe internally, and (when clinically appropriate) externally to the vulval area such as the labia. In some cases, treatment may include the area around the clitoris — this is discussed beforehand.
3. Aftercare guidance
   You leave the clinic with clear written instructions and a structured plan for follow-up and review.

Sessions, spacing and downtime (typical ranges)

Most protocols involve a course of treatments rather than a single session. The number of sessions and spacing depend on symptoms, tissue response and your goals. We will never promise a fixed outcome after a set number of sessions.

Most women describe minimal to moderate discomfort during treatment. You may notice temporary sensitivity, mild swelling, watery discharge, or light spotting afterwards.

Aftercare and restrictions

To reduce irritation and infection risk, we typically advise:

• avoid intercourse for a short period (we’ll confirm your individual timeframe)
• avoid tampons and internal products during the initial recovery window
• avoid hot baths, swimming and vigorous exercise for a short period if you feel sore
• use gentle, non-irritating cleansers only

You will receive written aftercare guidance tailored to your treatment.

Vaginal Comfort & Pelvic Support Package

At Chiswick Clinic we often find a combined approach is the most comprehensive way to improve intimate comfort and pelvic floor function — because symptoms commonly have more than one driver.

We offer two doctor-led package options (suitability is assessed for every modality):

• Juliet + Emsella (intimate comfort support plus pelvic floor strengthening)
• Juliet + Core to Floor (Emsculpt Neo) (intimate comfort support plus a structured pelvic strength programme)

Package pricing is available after assessment.

What Juliet cannot do (myth-busting)

Juliet is not a guarantee. It cannot:

• diagnose the cause of pain or irritation without medical assessment
• treat infections or replace appropriate medical treatment
• reliably treat complex pelvic pain conditions (and may worsen symptoms in some cases)
• replace pelvic floor physiotherapy for significant urinary symptoms
• act as a substitute for prolapse assessment or management
• promise cosmetic outcomes or “turn back the clock” claims

Our focus is symptom-led care, safety, and realistic expectations.

Alternatives and why we often combine treatments

Intimate symptoms rarely have a single cause. Your plan may include:

• vaginal moisturisers and lubricants
• discussion of hormonal options where appropriate
• pelvic floor physiotherapy and continence pathways
• our pelvic floor technologies (Emsella / Core to Floor with Emsculpt Neo) where suitable

When a combined plan is appropriate, we will explain why, how we will measure progress, and what to do if symptoms do not improve.