Radiofrequency Thermal Devices in Genital Rejuvenation
The radiofrequency (RF) thermal devices, such as Thermi VA, use radiofrequency – electric current – to heat up the tissue to cause the tissue to contract due to the thermal effect on the collagen and other tissue matrix molecules. The technology is an extension of the RF technology used for tightening of the skin of the face and body, with devices such as Thermage. The amount of heating is controlled with a thermostat system to maintain an optimal temperature of the tissue to be heated up. The heating effect, while deeper than that of CO2 laser, is still superficial in nature. It can heat up the tissue of the vaginal lining and the immediate underlying tissue, but most likely not the deeper muscle layer where most of the tissue defects occur with vaginal and vaginal opening relaxation secondary to vaginal childbirth. The vaginal muscle and deep fascia defect usually require tightening using sutures, often in a minimally invasive procedure setting.
Childbirth, aging, weight changes, loss of natural estrogen, surgery, cancer treatments, or lack of sexual activity can compromise vaginal contour and texture. The vaginal walls may become lax and sag. The vaginal surface may become dry and uncomfortable, losing its former moisture and elasticity, and the blood supply to the nerves and tissues beneath the vaginal walls may decrease. Some women experience vaginal canal narrowing and an uncomfortable sensation of dryness. Women who have vaginal dryness or vaginal atrophy may also have more urinary tract infections.
Vaginal rejuvenation means restoring healthy vaginal function. There are a variety of ways to restore healthy vaginal tissue. Dilators help expand narrow vaginal canals. Local topical vaginal estrogens help restore moisture and elasticity. Laser treatment has been used to resurface the vaginal walls, but laser treatments are painful and require downtime.
In 2015, the FDA approved ThermiVa for vaginal rejuvenation. ThermiVa uses radiofrequency waves to increase the blood supply to nerves and tissues using gentle temperature-controlled heat. This stimulates new collagen growth in the vaginal walls. The therapeutic heat treatment is comfortable. It feels like a hot stone massage. No anesthesia is needed, there are no needles involved, and there is no downtime.
Women who are cancer survivors are ideal candidates for ThermiVa treatment since any cancer survivors cannot safely use vaginal estrogens. No estrogen or medication is required to get the benefit of ThermiVa.
Urinary incontinence is one of women’s most common concerns. Even young women may report unexpected urine loss after gaining weight or giving birth. Stress incontinence – urine loss brought on by laughing, coughing, sneezing, jumping, skipping or running – can discourage women from exercising as much as they would like, or require them to do “bladder checks” before going to exercise, or force them to plan bathroom stops before going to work, school, shopping or meeting friends.
Another type of urinary incontinence is not related to activity. A woman may have trouble making it to the bathroom when her bladder is full. Or she may leak urine without warning, forcing her to wear pads or stop an enjoyable activity when she notices leakage.
Lax bladder support, due to weak tissue, causes the bladder to sag into the vagina. This condition, called a cystocele, is often present in women who have urinary incontinence. Gynecologists can assess the extent of the cystocele during a pelvic exam.
ThermiVa is a radiofrequency treatment that uses heat to increase blood supply to the nerves and tissues around the bladder and stimulate the formation of new collagen which strengthens bladder support. Women with urinary incontinence may benefit from this non-invasive treatment. There is no pain, no anesthesia is required, and there are no post-treatment activity restrictions.
If the bladder support is mild or moderate, the ThermiVa treatment will improve bladder support and decrease unplanned urine loss. ThermiVa may also reduce the frequency of urinary tract infections by restoring the health of the surrounding vaginal tissues (see vaginal rejuvenation).
A typical ThemiVa treatment lasts half an hour. Three treatments, scheduled one month apart are recommended. The benefits of treatment last 12 to 18 months or longer. If symptoms begin to recur, a touch-up treatment can provide relief.
The labia are the folds of skin outside the vagina. They may be enlarged enough to influence clothing choices at any age, even in young women. Some young women may inherit large labia that are prominent enough to dissuade them from wearing leggings, yoga pants, or high-cut bathing suits. Other women find that large labia interfere with intercourse. Labia may also enlarge after childbirth, with weight fluctuations, sedentary occupations, age, peri and postmenopause, and certain activities including prolonged cycling.
ThermiVa is a non-invasive treatment to shrink the labia and firm up the tissue. It uses radiofrequency energy to stimulate blood flow to the collagen beneath the labia and also increases the blood supply to the nerves and clitoris. This non-surgical approach consists of three office treatments, roughly 30 minutes each, one month apart. Many women feel improvements after the first treatment. The tissue continues to tighten and improve for another six months or more. While every woman is unique, some individuals may request a touch-up in six to twelve months to maintain the results. The treatment is comfortable, there are no needles and no anesthesia, and no downtime is needed after each treatment.