Female Genital Cosmetic Surgery (FGCS) refers to non-medically indicated cosmetic surgical procedures which change the structure and appearance of the healthy external or internal genitalia of women.
According to figures from Medicare, the number of women undergoing FCGS in Australia has increased dramatically in recent years.(25) It appears that in response to changing cultural norms this surgery is increasingly being sought by women who want to feel ‘normal’ or look ‘desirable’. As a result, general practitioners are increasingly managing patients who present seeking surgery due to concerns about the appearance of their genitalia.
The resource ‘Female genital cosmetic surgery – A resource for general practitioners and other health professionals RACGP 2015’ provides information on what FGCS is, the factors driving demand and a set of practical recommendations on how to manage women requesting referral for FGCS or expressing concerns regarding their genitalia.(26)
Recommendations from this resource are included below.
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Recommendations for management of patients requesting FGCS or expressing concern about their genitalia
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1.
Madhivanan P, Krupp K, Chandrasekaran V, Karat C, Arun A, Cohen CR, et al. Prevalence and correlates of Bacterial Vaginosis among young women of reproductive age in Mysore, India. Indian J Med Microbiol. 2008; 26(2):132-7.
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2.
Forcey D, Vodstrcil LA, Hocking JS, Fairley CK, Law M, McNair RP, et al. Factors associated with Bacterial Vaginosis among women who have sex with women: a systematic review. PLoS ONE. 2015; 10(12):e141905.
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Pirotta M, Fethers KA, Bradshaw CS. Bacterial Vaginosis: more questions than answers. Aust Fam Physician. 2009; 38(6):394-7.
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5.
Gottschick C, Zhi-Luo D, Vital M, Clarissa M, Abels C, Pieper DH, et al. Treatment of biofilms in Bacterial Vaginosis by an amphoteric tenside pessary-clinical study and microbiota analysis. Microbiome. 2017; 5(119).
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2015 Sexually Transmitted Disease Treatment Guidelines [Internet]. Centers for Disease Control and Prevention; 2015. Disease Characterized by Vaginal Discharge; [updated 2015 June 4; cited 2015 July 14]. Available from: https://www.cdc.gov/std/tg2015/vaginal-discharge.htm.
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9.
Bradshaw C, Morton AN, Hocking J, Garland SM, Morris LM, Moss LM, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006; 193(11):1478-86.
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10.
Car P. Chronic vaginal discharge: causes and management O&G. 2014; 16(3).
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11.
Saxon C, Edwards A, Rautemaa-Richardson R, Owen C, Nathan B, Plamer B et al. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019).[Internet]. British Association for Sexual Health and HIV: Clinical Effectiveness Group (CEG). 2019. Available from: https://www.bashhguidelines.org/media/1223/vvc-2019.pdf.
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12.
Fischer G. Coping with chronic vulvovaginal candidiasis. Medicine Today. 2014; 15(2):33-40.
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13.
Matheson A, Mazza D. Recurrent vulvovaginal candidiasis: A review of guideline recommendations. Aust N Z J Obstet Gynaecol. 2017; 57(2):139-45.
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21.
Fischer G, Bradford J. The Vulva: a Practical Handbook for Clinicians. 2nd Ed. Sydney, Australia: Cambridge University Press; 2016.
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22.
Nunns D, Mandal D, Byren M, McLelland J, Rani R, Cullimore J, et al. Guidelines for the management of vulvodynia. British Journal of Dermatology. 2010;162(6):1180-5.
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23.
Lynch PJ, Moyal-Barrocco M, Bogliatto F, Micheletti L, Scurry J. ISSVD classifications of vulvar dermatoses: pathologic subsets and their clinical correlates. J Reprod Med. 2007; 52(1): 3-9.
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25.
Ampt A, Roach V, Roberts CL. Vulvoplasty in New South Wales, 2001–2013: a population-based record linkage study. Med J Aus. 2016;205(8):365-9.
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