Rowena Walsh discovers that patients find Thermiva, a non-surgical ‘intimate rejuvenation’ , to be a life-changing experience
FORTY minutes was all it took to change Annette’s life. The mother of four from Cork had had a single session of a revolutionary vaginal rejuvenation procedure called Thermiva, and she and her husband were very happy with the results.
Eight months after her youngest child was born, 48-year-old Annette had been diagnosed with breast cancer. “I had a mastectomy along with radiation therapy and chemotherapy. I’m fine now, but it was tough especially as my son was so young at the time.”
Annette, a keen runner, is very fit and, after her cancer treatment, she began a new gym regime incorporating weight-bearing exercises, but something didn’t feel right down below. She began to feel increasingly aware of needing the loo and having the odd leak. “I would have to use the loo three times before leaving the house.”
Chemotherapy can damage a woman’s ovaries. They no longer produce oestrogen and menopause begins. A lack of oestrogen has a detrimental effect on the vagina, including irritation, dryness, and increased likelihood of infections such as thrush, as well as the thinning and sensitivity of skin which causes urinary difficulties.
Annette had previously had a breast reconstruction, so she didn’t want to have surgery again. last summer she opted for Thermiva, which has been described as a non-surgical ‘intimate rejuvenation’.
“From the very first session, I noticed a considerable difference,” says Annette. “I know it’s worked, and so does my husband. Everything has tightened up.”
Prof Sam Coulter-Smith is evangelical about the restorative effects of Thermiva, which regenerates the vaginal area and reverses some of the changes that have occurred as a result of ageing or childbirth, or both.
Coulter-Smith, a former master of Dublin’s Rotunda Hospital, and his colleague Dr Geraldine Connolly, an obstetrician and gynaecologist, offer the procedure from the private clinic in the hospital. The setting is reassuringly functional, rather than luxurious, as staff and patients crowd the corridor.
“The patients that we’ve treated over the last year or so have been very happy with the results of the procedure,” says Prof CoulterSmith.
“We felt that there was a real gap in the market for women with minor degrees of pelvic-floor prolapse and minor degrees of the ageing process. The vulva and the vagina do change with time and people are increasingly less happy to live with those changes.”
Prof Coulter-Smith and Dr Connolly had noticed that many women were unhappy with their recovery after childbirth. Typically, the vagina becomes laxer, the skin and vaginal tissues become looser and as a result, people don’t get the same satisfaction from sexual intercourse.
After women have had babies, there’s a spontaneous tightening up of the vaginal tissues that happens over the first couple of months. However, the bad news is that the pelvic-floor exercises that all mothers-to-be are encouraged to practise throughout their pregnancies continue to be essential afterwards in order to assist the natural process of strengthening those muscles.
But as Prof Coulter-Smith points out, a lot of people don’t do those exercises, or don’t do them well enough or don’t do enough of them, so over time those muscles become less well developed. “They become lax,” he says. “And then you get the onset of menopause, which makes everything worse.”
“I see quite a number of older women who are experiencing vaginal discomfort, including irritation, itch and general soreness,” says Dr Connolly. “We have traditionally prescribed an oestrogen cream but this can’t be used all the time without side-effects, so this treatment offered a way of alleviating the symptoms.”
Dr Connolly is also very keen to help younger women who have had breast cancer and are experiencing an early menopause because of their treatment.
“We started off with no patients,” says Prof Coulter-Smith. We bought the equipment and then we offered the service to some individuals who we felt might benefit from it. It was a learning curve from our point of view. We had to learn about it, learn what it could do, what it couldn’t do.”
Some people may find that they need a fourth treatment or, like Annette, a top-up several months after the initial treatment.
Prof Coulter-Smith is enthusiastic about the research to date. “There’s not that much out there in terms of science to say what happens after that, but, certainly, the initial results are very positive.”
Thermiva is suitable for those with mild to moderate symptoms, and Prof Coulter-Smith is quick to point out that it isn’t a panacea. “The treatment will improve things and will kickstart the process but we would always encourInstead age people not to rely on it alone and do their pelvic-floor exercises.”
There are two types of incontinence: Stress, which relates to pelvic-floor weakness and is a direct result of the trauma of childbirth, and urge, which involves an overactive bladder. Both require different treatments, but Prof CoulterSmith says that their experience to date is that Thermiva works well for those with urge incontinence and helps those with minor degrees of stress incontinence.
He says patients are getting up less frequently during the night and have less of an urgent need to go to the loo during the day.
“From a social point of view, they’re much more comfortable and that’s a really positive thing for quality of life.”
He says they have also had good results from those women who were dissatisfied with sexual function.
Prof Coulter-Smith and Dr Connolly are interested in treating those with clinical issues, rather than cosmetic ones. ”I don’t know how this service may develop we’re just at the start of it, but we’re concentrating on the medical aspect of it,” says Dr Connolly. If people want to access it for other reasons in the future, they may do, but that’s life, isn’t it?
Prof Coulter-Smith and Dr Connolly have treated 12 women to date and haven’t seen any drawbacks to the procedure so far.
Annette agrees. She didn’t experience any side-effects. “The worst thing is that I had to get all my pubic hair removed beforehand. I had to have a Hollywood wax, and that was the first time I had done that so I did feel embarrassed. However, once you have your consultation and you get it done, it’s fine.”
There is a surprising lack of discomfort surrounding the actual procedure.
“It’s a wand going around and around and there’s heat involved,” says Annette. “If you’re very sexual, you might have pleasurable feelings from it, but I don’t think that would happen.” She felt nothing at all during her sessions. “It was just a warm sensation, not painful at all. Having a smear test is 100 times more uncomfortable.”
Afterwards, Annette says that she could just walk out of the clinic and life continued as normal. “There was no funny sensation, it was just like getting waxed or having a check-up. Thermiva was the right thing for me.”
THE EXPERTS: Dr Geraldine Connolly and Prof Sam Coulter-Smith.