Approximately 50 percent of postmenopausal women suffer from the newly termed Genitourinary Syndrome of Menopause (GSM), which describes the constellation of interrelated exam findings and often troubling symptoms resulting from estrogen deficiency and affecting the external genitalia, vagina, urethra, and bladder. Estrogen deficiency, whether from menopause, medications, or chemotherapy, causes vulvovaginal atrophy, or thinning, which can cause vaginal discomfort, irritation, urinary stress incontinence, orgasmic dysfunction, diminished vaginal moisture, and vulvovaginal laxity (droopiness of the external genitalia.) This thinner, drier, and looser tissue may become more painful, particularly with intercourse, and can lead to loss of confidence, diminished interest in sex, and poor self-esteem. Far from being a part of “normal aging,” the effects of GSM can be far reaching and may seriously affect quality of life.

One doesn’t have to be postmenopausal to experience the effects of decreased vaginal muscle tone — just ask any new mom. Urinary stress incontinence is the leakage of urine that occurs during activities like sneezing, coughing, or exercise. Even more discouraging, these conditions are notoriously underreported, as women have long been body shamed by popular culture and a hereto now paternalistic medical system. Fortunately, this “taboo” is being slowly lifted, and there is recognition of, interest in, and treatments for many of the bothersome symptoms associated with GSM.

A recent Dermatologic Surgery article showed that three ThermiVa treatments, spaced at four-week intervals, had immediate effects on vulvovaginal laxity and had delayed but significant and positive effects on stress incontinence, atrophic vaginitis, lubrication, and sexual satisfaction. Using pre- and post-treatment biopsies, they showed increased collagen, elastin, blood vessel formation, and small nerve fibers. There were no adverse events following any of the treatments, and there was no downtime. The results last for about a year, and maintenance treatments are typically required.

ThermiVa is a non-surgical, non-hormonal, non-invasive treatment that uses radio frequency to heat tissue to 42º-45º C, which causes painless collagen remodeling and resulting improvements in all three layers of vaginal tissue. While the Thermi system is FDA-cleared and has been used safely for years in dermatology, there are currently no devices FDA-approved for vaginal rejuvenation.

ThermiVa is not appropriate for women who are pregnant or those that have metal implants in the pelvis, including mesh or copper wire IUDs. A negative PAP smear within the last year is also required. Whether you are a new mom, battling breast cancer, or suffering from GSM, call Thacker Dermatology and schedule an appointment to discuss if ThermiVa is right for you.

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Written by: Betsy Perry Backe, MD, FAAD