Introduction: Many treatment options were tried to reach satisfactory results for patients with loose vagina in order to improve their sexual life and urinary symptoms. Methods: 54 patients with loose vaginas and impaired sexual function participated in this study. Ultrasound gel was applied to a HIFU cartridge before inserting into the patient’s vagina and radiating the circumference with HIFU radiation. A group of patients was treated with HIFU alone (group I), and another group was treated with HIFU and systemic marine collagen (group II). We evaluated the patient’s vaginal pressure before and after treatment with a degree of patient satisfaction regarding their sexual function and urinary symptoms. Results: There was no significant difference between both groups regarding vaginal pressure before treatment, but there was a significant difference after treatment. The percentage of change was significantly higher in group II than group I, with more improvement in sexual life and urinary symptoms in group II. Conclusion: HIFU with oral intake of collagen resulted in significantly greater improvements in vaginal pressure compared with HIFU alone