Flacidez vaginal no menacme: prevalência, diagnóstico e tratamentos disponíveis

Abstract

Objetive: To analyze the prevalence, etiological and risk factors, diagnostic methods, and therapeutic approaches for vaginal laxity (VL) in women of reproductive age, compiling recent scientific evidence to support clinical practice and guide management and prevention strategies. Data Sources: The PubMed and UpToDate databases were consulted, covering publications between 2014 and July 2025. The descriptors "VAGINAL LAXITY" AND "REPRODUCTIVE YEARS" OR "REPRODUCTIVE AGE" OR "MENSTRUAL CYCLE" AND "DIAGNOSIS" AND "TREATMENT" AND "MANAGEMENT" AND "SEXUAL FUNCTION" were used, with Boolean operators applied to refine the search. Studies in English, Portuguese, and Spanish were included.Study Selection: A total of 325 articles were identified, of which 104 were excluded due to duplication. After screening by title and abstract in the Rayyan Qatar Computing Research Institute software, 190 studies were removed for not meeting the inclusion criteria. Nine articles were included for final analysis, comprising randomized clinical trials, prospective studies, and meta-analyses. The risk of bias was assessed according to the Cochrane Collaboration tool, considering random sequence generation, allocation concealment, blinding, and data completeness. Data Collection: Three independent reviewers extracted information on prevalence, etiology, diagnosis, and treatment, resolving discrepancies by consensus. Data Synthesis: Parity and repetitive pelvic strain were the main risk factors. Standardized questionnaires, such as the Female Sexual Function Index and the Vaginal Laxity Questionnaire, were the most used diagnostic methods. Conservative interventions, such as pelvic floor exercises, and minimally invasive procedures, such as radiofrequency, showed significant improvement in laxity and sexual function, while surgical procedures presented a high satisfaction rate and a low complication index. Conclusion: Vaginal laxity during the reproductive years is a prevalent and still under diagnosed condition with a relevant impact on women's quality of life and sexual function. The methodological heterogeneity among the studies limits the comparability of the results, highlighting the need for diagnostic standardization and controlled clinical trials to robustly evaluate the efficacy and safety of the different therapeutic approaches available.