Cancer treatments, menopause & childbirth can play havoc with your private parts, but there is help at hand

Dr A Bolin and Fiona Clark

There’s so much more to vaginal rejuvenation than a designer vagina. Gynaecologist Onsy Morris explains how it can benefit women after childbirth, cancer treatments and menopause.

 

There’s no doubt about it – a woman’s body goes through a lot. And it’s not just the visible bits that suffer from wear and tear. Down below can go through some extraordinary changes too. Childbirth, menopause and simply aging can take their toll on the pelvic floor, vagina and external genitalia. And if you’ve been ill with cancer, certain treatments can really knock those regions around as well.

The upshot of all of these can be a host of symptoms including a dry vagina, a burning sensation, painful sex (and not surprisingly a low libido), plus urinary incontinence.

According to Mr Onsy Morris, a consultant obstetrician and gynaecologist at Kingston Hospital, these can have a huge impact on womens’ lives. Relationships can suffer and basic day to day events such as jogging, sneezing, coughing and even laughing can become a source of fear. In extreme cases the dryness can be too uncomfortable to walk.

And yet, he says, people are afraid to talk about it.

“After 40 years of practice I can say that I’ve seen loads of women with these types of problems but they continue to suffer without talking about it. My message is: It is time to talk about it and say ‘I have this problem can I be helped?’ The answer is yes, there are non-invasive, low-risk and low-complication procedures that can help, so there’s no need to sweep it under the carpet”.

 

Why does this happen?

As we age we lose collagen – about 1% a year after the age of 30, it’s said. This doesn’t just happen on our faces, but all over our bodies. The result in the genital area is a thinning of the vaginal wall and skin on the external genitalia, or labia. When this happens, we are more prone to a dry vagina and as a result, painful sex.

The thinner vaginal wall can cause functional changes in the region too with the vagina providing less support for the urethra which sits in front of it. The result is urinary leakage when you sneeze, cough, laugh or move or in other words an ‘ooops’ moment as they call it on the ads for adult absorbent underwear.

Then there’s menopause. The loss of oestrogen as we age also affects our skin, making it thinner and more prone to wrinkles – and it’s not just your face, it’s all over our body.

Even if you haven’t got that far yet, there’s the stress of childbirth. The pressure on your pelvic floor, the potential for laxity after a vaginal delivery plus the hormonal changes that come with pregnancy can also exacerbate all these types of problems.

But it’s not just natural processes that can have an effect. The chance of losing your hair or nausea with certain cancer treatments is well known, but what no one talks about is the effect on your private parts.

Mr Morris says radiation treatments for cervical cancer, endometrial cancer and vulvo-vaginal cancers, can cause burns and scar tissue formation which can make the vaginal walls stiff, tight and less elastic. This can be devastating for a woman’s sex life, he says.

“It can have a profound effect on her ability to enjoy a normal sex life with her partner due to the discomfort and pain she might experience after her treatment”.

If you’ve been prescribed Tamoxifen as part of your long-term management for oestrogen receptor positive breast cancer, it can also play havoc with your sex life.

“It can cause symptoms similar to those experienced in the menopause, such as vaginal atrophy or thinning of the vagina, dryness, burning, tightness and pain with intercourse.  Mostly this is devastating in relatively young women where oestrogen therapy is contraindicated because of their history of breast cancer.”

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What can be done?

Mr Morris says there are various options. Oestrogen creams and lubricant applied locally can help temporarily relieve the situation in some cases and HRT can also make a significant difference to many women. There are however, many women who aren’t keen on HRT or for whom it’s not an option due to their own health or family history of breast cancer. Surgery is another option, but it too has its drawbacks in terms of scarring, surgical risks and downtime.

But there are other non-invasive vaginal rejuvenation techniques that can really make a difference, he says. These range from injecting fillers or platelet rich plasma into the vaginal wall and labia, to radiofrequency (RF) procedures (ThermiVa or Geneveve) that heat the internal walls of the vagina and the external labia for a tightening and collagen boosting effect.

 

How does radiofrequency work?

Mr Morris favours the ThermiVa RF device which he says delivers both instant and long-term results. He says the RF “generates controlled heat. This stimulates new production of collagen and elastin fibres, replacing those which were lost or damaged.”

These then got to work to “rebuild the tissue in the vagina and labia, as well as around the urethra and bladder neck. This can improve the function and the aesthetic appearance of the area”.

The results speak for themselves with 93% of women saying they’re satisfied with the outcome.

 

How does it compare to other treatment options?

Mr Morris says radiofrequency vaginal rejuvenation has advantages over fillers for a number of reasons.

“In gynaecology, fillers may be used as a functional solution to treat incontinence. … However, this only succeeds for 50% of procedures and it only lasts 2-3 years. ThermiVa uses one’s own mechanism to boost collagen and elastin formation, and is a less risky procedure”, he says.

Injectables, can carry an infection risk, bruising and swelling. That said, any device that heats, like ThermiVa, should only be operated by well-trained medical staff as burns could occur, he warns.

He says it also has advantages over surgery.

“Strictly speaking surgery cannot achieve vaginal rejuvenation. It can achieve vaginal tightening by excising redundant vaginal tissue and closing defects that were created by birth trauma, but vaginal rejuvenation using ThermiVa involves creating new collagen and elastin fibres that relatively restores vaginal anatomy to how it was before child bearing”, he says.

Another disadvantage of surgery is that it can decrease sensitivity.

“Surgery creates scars inside the vagina which is a sexual organ. Scars are usually insensitive as using a knife on tissues cuts nerve endings thus disconnecting that tissue from the central nervous system”, he adds.

However, surgery, does have its place.  Mr Morris says it is great for severe stages of prolapse, but for mild to moderate laxity ThermiVa is more appropriate.

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What does ThermiVa feel like?

It shouldn’t feel like anything more than mild warmth as the ‘wand’ or hand-held device is moved slowly around the area being treated.

 

How long does it take and how many treatments will I need?

About 20 minutes on each area.  Three treatments are required – each of them four weeks apart. A maintenance or ‘top up’ treatment is advised every 12 months or as symptoms dictate.

 

Who can benefit from the treatment?

  • Perimenopausal and Menopausal women
  • Women who have had cancer treatments
  • Women who have given birth and have post-partum laxity
  • Women who have urinary incontinence

 

Who can’t have the treatment?

ThermiVa is suitable for the vast majority of women but the procedure should not be used if:

  • You are pregnant
  • If you have an active sexually transmitted disease
  • If you are suffering from a urinary tract infection
  • If you have any cardiac devices such as a pacemaker
  • If you suffer stage 2 pelvic organ prolapse or higher
  • If you have had any form of recent vaginal surgery.

 

How much does it cost?

This will depend on the practitioner and the number of treatments required, but you can expect to pay between £1500-3500.

Compare that to the cost of a life time of super absorbent underpants and it may not seem so much!

 

You can book with Mr Onsy Morris here: https://www.harleystreetemporium.com/doctors/mr-onsy-morris-gynaecologist/

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