Female Intimate Surgeries May Limit Ability to Have Orgasms

Until seven years ago, the São Paulo businesswoman Cristina (surname hidden, on request), 39, felt ashamed when having sex.

The labia minora slightly surpassed the major ones and what he saw as excess “always bothered”.

“I was ashamed of the relationship, especially on the first date,” he says. She also kept fixing the skin in the bath, putting it inside with her hand.

This made her join the thousands of Brazilians who had their labia minora reduced through surgery. The operation, called labiaplasty or nymphoplasty, is the most sought-after intimate surgery in the country, the world champion in the number of procedures.

Some women, like Cristina, and researchers in the field say there are benefits.

A hypothesis little discussed, however, is that of the risks involved. Nearby areas, including the clitoris, can be reached through its blood supply and sensory innervation of pleasure. Among the potential effects in these cases are loss of sensitivity to touch and decreased ability to orgasm – although they are considered rare.

“There is an average rate of complications of more or less 5% in intimate surgeries”, says Tatiana Turini da Cunha, plastic surgeon and member of the SBPC (Brazilian Society of Plastic Surgery), based on scientific studies.

Temporary bruising, hypersensitivity, scarring, infection, pain with sex, stitches that eventually break open or loss of sensation are statistical examples of what procedures can cause.

“The most common complaint of patients, when they come from other surgeons who have already been operated on, is that the labia minora are still large, asymmetrical or have had the amputation, [ocorreu] the very large removal of the labrum minor”, says

The chance of decreased sensitivity would be small because nymphoplasty must, technically, be superficial and preserve the nervous structure. Incisions that remove the entire edge of the region are the ones that can cause complications.

Online reports identified by Sheet mix the benefits of labiaplasty and other procedures with complaints about the consequences of unexpected clitoral injuries.

Paula (not her real name) says she had her organ affected and says she is devastated by what she calls “a general loss of sensitivity in the area”. Another boarding student emphasizes that she regrets having removed the excess from her labia minora every day. “In addition to having a much uglier vulva, I can no longer have an orgasm. I lost all sensitivity in the clitoris”, she reports.

“Little excised labia” and “clitoris removed” are used by a third woman to describe the results of her surgery. The pleasure, she said, has diminished. And when she is reaching orgasm, the feeling is now “super light”.

In a case that reached the Court, it was confirmed that only “remnants” of the labia minora remained after the procedure, in addition to an incorrigible cleft in the clitoris. In another lawsuit, a judge speaks of “mutilation of the clitoris and the labia majora”, with “impairment of the woman’s sexual life”, in addition to “moral pain of high severity and psychological shocks”.

The experts interviewed by the report did not analyze the particularities of the testimonies because they were unaware of variables that could conspire in favor or against: under what circumstances the surgeries were performed, what was the experience of the professionals involved, the technique chosen and aspects related to the psyche of the patients.

In 2020 alone, 20,300 labiaplasties were performed in Brazil. Since 2014, there have been almost 143,000, which represents a growth rate of 3.6% per year, despite a temporary setback with the pandemic.

The numbers, calculated from data from the International Society for Aesthetic Plastic Surgery, do not include surgeries with gynecologists and urologists.

When Cristina decided to perform the procedure, she heard from friends and the gynecologist about the risk of losing sensitivity.

“I was a little scared. But a little just because the doctor who performed the surgery was very reputable and told me that he wouldn’t even come close to the area where I feel the pleasure. He said that the amount he was going to cut was so symbolic that it wasn’t going to change the question of having or not having an orgasm and it didn’t.”

Experts advise that support and discussions with professionals about benefits and risks before any surgery are essential.

Lucia Alves Silva Lara, a professor at the USP School of Medicine (University of São Paulo) and president of the National Commission on Sexology at Febrasgo (Brazilian Federation of Gynecology and Obstetrics), says that if any complications occur, microsurgery can help restore the occupation. “But it’s a complex, expensive surgery and we don’t have this resource on a daily basis in Brazil,” she says.

Performed with the proper technique, he adds, nymphoplasty does not change pleasure either for better or for worse. And whether it can lead to a reduction or difficulty in orgasm is not yet proven in scientific works.

“In clitoral surgery, it is more opportune to happen due to the dorsal path of the organ’s innervation. However, there are no data regarding the prevalence of this complication”, observes Lara.

The loss of sensitivity in the female pleasure organ, when it happens, can be temporary or permanent, points out Ubirajara Barroso Júnior, director of the Higher School of Urology of the Brazilian Society of Urology and a specialist in genital reconstruction.

The most performed direct intervention in the area and one of those that bring risk is the reduction of the enlarged clitoris due to congenital clitoromegaly, when there is an increase in testosterone by the body itself or by the use of anabolic steroids.

“An enlarged clitoris can make women stop going to the beach to avoid wearing bathing suits or stop having sex because they are ashamed of the organ that, when aroused, can look like a penis”, says the specialist.

In the most performed surgery, there is a need to separate the nerves and vessels that supply the region with the removal of the cavernous bodies, that is, the tissue that fills with blood and goes into erection when there is sexual arousal.

“That’s why some women complain of loss of sensitivity and reduced pleasure with this procedure, which I don’t do”, he points out. “Someone who performs surgery in the region and does not have extensive knowledge of this anatomy can even take the risk of organ loss.”

The doctor says that newer techniques, such as corporoplasty, which he developed with the team in Brazil and which has already reached the SUS (Unified Health System), allow the performance of procedures in the area without touching the nerves and cavernous bodies, reducing these scratchs.