By Cynthia K. Davis MD

Women talk – but not about some things which are common and bothersome. They are embarrassed by the changes they’ve noticed. They don’t want their husband to know that sex has become painful. Or their friends to know that they are having bladder problems such as urgency and leakage. People might think they are getting old! But they SHOULD talk – to their doctor! Because these problems can be helped – without medication. And that may make them feel younger, or at least happier.

The changes which occur as we age are due to loss of collagen strength and elasticity. You know – the little wrinkles in front of your ears, the once-perky boobs now size 36 long. And the vagina, labia and bladder lose collagen strength and elasticity, too. Sex can become painful, arousal may be decreased, and the way things look changes too, which can lead to insecurity about your self-image, which leads to NO INTEREST in sex. This may be hard to explain to your husband or partner, but it has great impact on your relationship.

Then there are the bladder issues: you know where every bathroom in town is located. You have to go often, and urgently. Sometimes, you wear a pad, “just in case”. Sometimes you laugh so hard, the tears run down your legs. Oops, you didn’t cross your legs in time. You can’t do jumping jacks anymore, or run, or…do lots of things. You limit your activities and your life seems smaller.

What might your doctor say, if you talk to her about these problems? Vaginal estrogen has been around for years, and often helps painful sex. It may be helpful for bladder issues, too. But many women can’t use estrogen, because they have had breast cancer, and some women don’t want to use estrogen. There is another option, now. ThermiVa is an office procedure using radiofrequency energy to cause growth of new collagen in the vagina and labia. Since the bladder is immediately next to the vagina, it may also benefit from ThermiVa. Many patients report sex is no longer painful, they notice increased vaginal lubrication, less bladder urgency and frequency – even less leakage.

The procedure does not require any anesthesia, and there is no wait time for healing. 3 treatments over 3 months are standard, and sometimes a refresher treatment after a year.

So…how do you find out if this is might work for you? Schedule an appointment to discuss your problems. You will have an exam, and the doctor will explain whether ThermiVa is a good option for you. Other treatments may be discussed.

Women for whom ThermiVa is NOT appropriate: those who have a cardiac pacemaker, AICDs, a metal IUD, mechanical heart valve, or electrical stimulation implant. ThermiVa should not be done while a woman has a UTI, or a vaginal infection. Or is pregnant.

If you choose ThermiVa, the 3 treatments will be scheduled at one-month intervals. At each treatment, you will be asked to empty your bladder, and remove all metal from your body (jewelry, and bra if metal clasp). You will lie in the usual position for a pelvic exam, and be covered with a warm blanket and warm socks. A grounding pad will be applied to one leg. Warm gel will be inserted into your vagina, and applied to your labia. The radiofrequency energy applicator, called a wand, is inserted into your vagina and moved in circles to cover the entire area. The treatment length is usually 20 minutes inside the vagina, and 10-20 minutes on the external labia. You will feel warmth during the procedure. The doctor monitors the temperature of the wand throughout the procedure. If it is uncomfortable, the procedure is stopped for a minute, and the temperature is lowered. When the procedure is over, you will continue to feel warmth for a while, and a little swelling. You may notice a pink discharge. These are all normal, and will gradually subside. There are no restrictions on your activities after the procedure. You do not have to wait any certain period of time before you have sex.

If this seems too good to be true, do your own research. This procedure has been discussed on The View, and many online forums. Realself.com has many patient reviews. Check it out!

Cynthia K. Davis, MD
2061 Englewood Road, Englewood, FL.  34223

About Dr. Davis:
Undergraduate education: The Pennsylvania State University, BS in biology 1977
Graduate education: University of Pittsburgh
School of Medicine, MD 1981
Residencies: Family Practice at Allegheny
Family Physicians 1981-1984
Ob/Gyn at Bowman Gray School of medicine and associated hospitals 1984-1987
Work history: Ob/Gyn at Quincy Hospital in Quincy, Mass, 1987-1992
Ob/Gyn at Mount Auburn Hospital in Cambridge, Mass, 1992-1994
Gynecology only in Englewood, FL 1995-present
Board-certified in Ob/Gyn since December 1989
Loves animals; has 2 horses, 3 pigs, 2 dogs, 8 cats (all rescues) and 11 chickens

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