Do vaginal tightening creams work?

Question

From a billboard in Ulaanbaatar, Mongolia (population 1.4 million)

Vagina Tight
залуужуулах цогц эмчилгээ [Google translate from Mongolian into English: comprehensive rejuvenation treatment]

(I think it is talking about creams - I might be wrong and it's talking about surgery, but the following is definitely talking about creams)

'Feel tight and wanted again!' The disturbing 'vaginal shrinking' creams that promise to make you feel like a virgin again from the Daily Mail gives more information on vaginal tightening creams. It says that there are several of them, and that some people say they work, and some people say they don't work

'Recapture your vagina's youth so you can feel tight and wanted again' - the slogan accompanying one of several creams currently on the market which claim to 'shrink' and 'tighten' your lady bits.

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18 Again, with its acid pink branding, isn't the only cream in its category. None of them appear to be FDA approved, but this is not a legal requirement for companies selling such products.

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Tellingly, the product reviews on Amazon are extremely polarized, as with all of the other similar creams; with ratings of either five stars or one. 'You do become tight and stay tight. Worth the money,' one review reads. 'I tried it and not only did it not work whatsoever, but it also caused me to get a bladder infection and a yeast infection,' reads another.

Some pages talk about whether tightening creams work or not, but they don't seem that reliable. For example Do Vagina Tightening Creams Really Work? and Here Are the Real and Ridiculous Reviews for Vaginal Shrinking Cream. One product's site has a page titled Clinical Trials, which talks about a "Prospective, Randomized, Double-Blind, Placebo controlled Pilot Trial of the efficacy and safety of PK24® for women with vaginal wall relaxation", but the page doesn't indicate how the control group fared.

Can you tighten your vagina with one of these creams?

Answer 1

The answer is "probably not". An in-depth medical review here has some exceedingly good points about why. To summarize the main factors: vaginal tightness is mainly controlled by deeper layers of muscle in the pelvic floor, which most topical creams will not easily penetrate to. There is also little to no evidence that the ingredients in these creams increase blood flow to the targeted muscles, or any other effects that may aid in muscle tone improvement.

Many of the ingredients do have astringent properties, which will cause a sensation of tightness for the user, similar to mouth pucker. They are also likely to mess up the microbiome of the user, leading to additional discomfort. Since generally vaginal tightness can be inversely correlated with relaxation and arousal, being uncomfortable physically or emotionally could certainly make the orifice feel tighter, so that may be part of the explanation.

Another part of the issue is that many of these products' usage guidelines state that after application you also perform vaginal strengthening exercises. The cream itself is likely not contributing to the positive improvements reported by some, and instead the muscle strengthening is the actual helpful factor.