Find­ing form

Rowena Walsh dis­cov­ers that pa­tients find Ther­miva, a non-sur­gi­cal ‘in­ti­mate re­ju­ve­na­tion’ , to be a life-chang­ing ex­pe­ri­ence

Irish Examiner - Feelgood - - Feature -

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.

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