The female vagina is a remarkable sheath that comprises the lower birth canal and reproductive tract. The lining is composed of a mucous membrane that is elastic enough to allow the passage of a large baby, and then regain its pre-pregnant configuration. It is attached to other pelvic structures by a complex system of muscles, ligamentous connective tissues, and collagen fibers.
During the reproductive years, the vaginal lining also has numerous folds and remains fairly elastic to allow for sexual intercourse and the passage of a baby, as mentioned above. This lining is lubricated by glands that produce a mucous containing antibacterial properties. This lubrication changes throughout the menstrual cycle, generally being more copious during the time of ovulation. The consistency changes at that time for the purpose of allowing sperm to be transported through the cervix and uterus to the upper reproductive tract where fertilization occurs in the fallopian tube.
With menopause and the decline of hormone production, these tissues usually lose their elasticity and the ability to produce mucous. The tissues become thinned out and more susceptible to injury and infection. This can also affect bladder function with many women experiencing urinary urgency and bladder infections, especially after vaginal intercourse.
Prior to menopause, some women experience a relaxation/stretching of the vaginal sheath due to pregnancy or sexual practices. This relaxation is often problematic for proper bladder control or sexual satisfaction. We will discuss some of the methods currently available to improve vaginal function.
Kegel exercises are used to facilitate strengthening of the muscles that help control bowel and bladder function and to help prevent vaginal relaxation. There are slow and fast twitch muscles in the pelvic floor. The slow twitch muscles can be strengthened by squeezing the muscles of the pelvic floor and holding this squeeze for a count of 10. Repeat the contraction to a count of two to stimulate the fast twitch muscles. This process should be completed 20-25 times a day.
In addition to these exercises, I ask my patients to practice the Kegel exercise while on the toilet emptying the bladder. Let a little urine pass, then try to stop the flow. This acts as behavior modification and prepares one to begin the squeeze process ahead of a cough or sneeze.
We also recommend a special device called an EMSELLA chair. The chair employs a powerful magnet upon which the patient sits. The magnet stimulates very strong Kegel contractions, much stronger than most women can perform, and does so at the rate of about 12,000 contractions in a 28-minute treatment cycle. This non-invasive procedure is usually employed twice a week for three weeks, but can be adjusted depending on the severity of the problem. The treatment is totally painless, requires no preparation, and has very few contraindications. Many women with urinary incontinence and pelvic floor relaxation find great relief with this technique.
Platelet rich plasma infusions: The Oshot
The Oshot is a quick, mostly painless procedure. Platelet rich plasma is obtained by drawing blood from the patient, using a special centrifuge to extract a high concentration of platelets which are known to contain dozens of growth factors. After utilizing an activation technique with Low Intensity Sound Waves, and a applying numbing cream to the affected areas, the platelet-rich fluid is infused into the clitoris and under the urethra to enhance orgasmic function and improve bladder control. We perform this procedure in our Bloomington office. It requires no advance preparation and there is no down time associated with post-procedural recovery.
Low Intensity Extracorporeal Sound Wave Therapy (LiESWT)
Sound waves have been used in medicine for a long time. Some are high intensity while others are ultrasonic. At Vibrant Life, we utilize LiEWST to improve the vascular supply to the genital area.
You may have heard of Gainswave therapy, which employs this technique to help men with erectile dysfunction. The same technique is utilized in women to improve their genital function. We use a series of six treatments, once per week, to help activate the platelets utilized with the OShot (if performed), and to further improve vaginal function.
CO2RE Intima Laser Therapy
Another option for vaginal rejuvenation involves the use of laser therapy. We use the Candela CO2RE Intima Laser therapy to rejuvenate the vaginal lining. As mentioned above, the vaginal tissues thin out in menopause and lose elasticity. The CO2RE Intima machine uses advanced ablative laser therapy to create a healing environment in the vagina which thickens the vaginal lining, enhance lubrication, elasticity, and sensation.This is especially important for women suffering from atrophic vaginitis, or as it is more recently described as “Genitourinary Syndrome of Menopause” (GSM).
The CO2RE Intima Laser is even approved for use in the treatment of urinary incontinence! Additionally, this treatment is also used externally for the treatment of Lichen Sclerosis (a chronic painful and itchy skin condition of the external vaginal tissues). The CO2RE Intima Laser can also be used to treat a variety of facial and other skin conditions, such as wrinkles, stretch marks, and age spots.
The ideal process for rejuvenating the vaginal tissue is to restore the estrogen content, which allows for the production of mucous and restores elasticity and sensation. Studies have shown restoring estrogen is very effective. There have also been several studies comparing vaginal CO2RE Laser treatments to estrogen therapy and they are equally effective. Estrogen has additional benefits that reduce hot flashes, night sweats, and irritability. A large European study also revealed that women using vaginal estrogen alone cut their risk of heart attack in half, compared to women who use nothing.
We realize that not all women can or want to use vaginal estrogen. There are other options, including a variety of treatments that do not contain hormones which help with vaginal dryness. However, these options do not restore the elasticity and natural mucous production obtained by the OShot, CO2RE Intima laser, LiESWT, and estrogen products.
Call our office to learn more about our vaginal rejuvenation procedures.