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The Vagina Dialogues

By Christine Hatfield, MD

It’s no secret that many women are prone to experiencing vaginal concerns due to childbirth or the aging process. But did you know that treatment options are available?

You probably already know the female vagina is seriously impressive. This amazing body part can bring about intense pleasure, help predict when you are fertile, and even transport another tiny human being into the world. In short, it’s pretty awesome. That’s why I think it’s crucial to keep your vagina in its best working condition for life!

When the vagina is not in its optimal state, women may experience pain or decreased sensation with sex, dryness, itching, infections, abnormal bleeding or even leakage from the bladder.  Women frequently ignore these symptoms, hoping they will go away. Very few will actually speak with their health care provider because they are embarrassed or do not realize that treatment options are available for these common conditions:

Vaginal Relaxation Syndrome

This is essentially a laxity of the vaginal wall.  In other words, the vagina becomes loose, resulting in decreased friction and less sexual satisfaction for both a woman and her partner.  Stretching of the vaginal walls during childbirth is the most common reason for vaginal relaxation to develop.  But natural aging and the gradual loss of collagen contribute as well.  Collagen is the most abundant protein in the body and is the substance that holds us together, providing structure and form to our connective tissues.  As we age, we make less and less.  Without collagen, tissues everywhere, including in the vagina, become weak and saggy.

Vaginal Atrophy

The vaginal tissues are very sensitive to the loss of estrogen that begins at midlife. Without the stimulating effects of estrogen, the vagina becomes thin (atrophic), dry, and loses its natural elasticity. This leads to painful intercourse, itching, infections, bleeding and urine leakage.  When sex is uncomfortable, women tend to avoid it, making vaginal atrophy the number one reason for low sex drive after 40.

Stress Urinary Incontinence

Leakage of urine when you cough, sneeze, laugh, or exercise can be embarrassing and frustrating. The tissues surrounding the vagina normally provide support for the bladder neck (urethra), which keeps us dry. Childbirth and advancing age damage and thin this tissue, weakening the supports. This allows urine to leak when there is increased pressure on the bladder (like when jumping on a trampoline). Stress incontinence is a social inconvenience that creates low self esteem and isolation.

Treatment Options

Vaginal atrophy is usually addressed with topical hormone therapy. While treatment is effective and safe, some women do not get complete resolution of symptoms, especially if the vaginal walls are sagging or there is significant bladder leakage. Kegel exercises work well to address pelvic muscle weakness and can improve both vaginal tone and mild incontinence. However, they must be done properly and frequently to get the desired results. For those with pelvic pain or severe incontinence, working with a pelvic floor physiotherapist can be helpful. Surgical procedures work by tightening the vaginal tissues or inserting supportive mesh where needed.  This option is reserved for those with advanced conditions and is accompanied by lengthy recovery times.

Turning Back the Clock

While there is still a role for traditional medical therapies, a more modern approach is Laser Vaginal Rejuvenation. This technique, performed by a trained physician, utilizes a medical laser to encourage the body to make new collagen. The vaginal tissues are revitalized by the increase in collagen and function returns to normal. Following laser stimulation of collagen synthesis, the vagina and surrounding tissues tighten and become more elastic, better hydrated, and healthier. In essence, the vagina gets younger!

This simple, non-surgical office procedure is highly effective, pain free, and safe. You can leave immediately after having it done and continue your daily routine with no recovery time. Improvement is seen within the first three weeks and continues over a period of months as the body keeps making new collagen, with results lasting up to two years. 

Following Laser Vaginal Rejuvenation, 94 percent of women indicate they are dry and more than 95 percent report improved sexual satisfaction. How can we argue with these numbers?

Laser Vaginal Rejuvenation is safe for women of all ages. It is not recommended for heavy smokers, if your lifestyle involves excessive lifting or for women who are extremely overweight.  This procedure can be done even if you have had a previous bladder lift (with or without a mesh sling). Having this treatment will not affect future pregnancy or childbirth.

If you would like more information about Laser Vaginal Rejuvenation or to schedule a consultation, you are welcome to contact North Okanagan Women’s Health in Vernon.

Christine Hatfield, MD, a gynecologist and anti-aging specialist, is the medical director of NOWhealth (North Okanagan Women’s Health) in Vernon.  She practises integrative medicine and specializes in hormone balancing for women of all ages. Visit www.nowhealth.ca or call 250-542-4490 for an appointment.

*Reprint from our Spring 2016 Issue

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