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What is Vaginal Reconditioning?
Vaginal Reconditioning is a dedicated program that optimises vaginal function after vaginal delivery of your newborn. There are three components:
- The initial consultation includes a thorough evaluation of an injury sustained by the vagina during pregnancy and delivery. The interrogation into the ligament support, the endopelvic fascia and the pelvic floor musculature is enhanced by 2D and 3D ultrasound imaging,
- The prescription of a customised regimen to train the pelvic floor muscle, with detail instructions and target setting. Additional supplementation to boost vaginal skin health may be advised.
- Global reconditioning of the vaginal function: use non-ablative vaginal laser reconditioning and/or radio frequency therapy to achieve vaginal tightening, restore vaginal skin health and augment vaginal sensation.
Who Needs It and Why?
- Vaginal Reconditioning is designed for every woman with a recent vaginal delivery.
- Forty weeks of pregnancy modifies the vaginal integrity via hormonal changes and the downward pressure effect of the fetus. Further significant trauma to the pelvic floor and vagina occurs as the baby is delivered.
- Excessive stretching of the vaginal canal during labour may cause irrevocable alterations to the structural support of the pelvic organs. Soon after delivery, besides the issues of perineal pain, poor control of urine and stool, many women suffer a partial loss of physical and sexual sensation during sex. In essence, there is a pervasive decline in the quality of sexual life after pregnancy, albeit not vocalised.
- Vaginal Reconditioning serves to restore the vaginal skin changes and arrest its decline before it becomes more symptomatic.
How is the Vagina Reconditioning?
- The reconditioning process begins with a diagnostic workup on the severity of damage in the genito-pelvic elements. The pelvic muscle weakness will be improved by pelvic floor exercises using biofeedback. Vaginal laxity will be reduced with either vaginal laser reconditioning or vaginal radiofrequency therapy.
How Effective is Vaginal Reconditioning?
- Pelvic floor muscle tone is vital to vaginal function, and the process of restoring it through customised training is proven.
- While laser energy and radiofrequency have been used extensively to “tighten” skin for nearly twenty years, only in the last few years has it been applied to the vaginal and vulvar skin. Centres in Italy, Slovenia, Canada, USA and Latin America have shown commendable efficacies of these treatment protocols. The use of these modalities has opened up a new paradigm in managing vaginal laxity and early pelvic organ prolapse.
When is the Right Time for Vaginal Reconditioning?
- Vaginal Reconditioning is initiated at the third month after delivery, for pregnancy-related physiological effects would mostly be resolved by then. The residual physical distortion of the vaginal canal is stable and the natural restoration process would be complete.
- The program duration is customised based on the severity of the vaginal injury and desired improvement. It takes four to six weeks for tissue remodelling to express symptom recovery.
Is There Any Down Time, and Any Side Effects?
- Since Vaginal Reconditioning uses heat energy to restore intrinsic tissue repair, and there’s no need for systemic medication, there is no long-term side effects or complications. Minor skin irritation may occur after laser treatment, but they usually disappear in less than a day. There is no surgical intervention and post treatment recuperation is not needed.
What is Vaginal Laxity?
The first vaginal delivery causes the most physical changes for the woman’s body. Our skin is elastic to a point, beyond which the underlying dermal tissue will tear with over-stretching. The skin becomes permanently damaged with loss of resilience, and the increased skin surface does not return to its original size.
The severity of vaginal laxity increases with more vaginal deliveries, greater trauma incurred during each birth, the size of the baby, and/or the need for forceps to assist in the delivery.
Vaginal laxity is prevalent, and it worsens with advancing years because of age-related changes in the connective tissue.
Although the excessive vaginal folds have been recognised all these years amongst women who have had children, the condition has been left undiagnosed.
Women, as well as their doctors, tolerated it as a consequence of childbirth.
The subtle discomfort and physical distortion of vaginal laxity is over-shadowed by the new priorities and responsibilities of motherhood. For so long, vaginal health has been lowly prioritised as “unimportant” and it is embarrassing to highlight its discomfort to the partner or the doctor.
Doctors also made no attempt to diagnose vaginal laxity because there has been no appropriate treatment developed to tackle the issue. Vaginal laxity has been allowed to persist, until progressing to more severe stages of pelvic organ prolapse, before action is taken.
Studies in the early millennium reported the effects of pregnancy on female sexual function; describing how physical stretching reduces the sensation of the genito-pelvic skin during sexual intercourse. This lesser pleasurable sensation results in loss of sexual desire and a poorer body image.
ENHANCING SEXUAL SATISFACTION – ENERGY-BASED VAGINAL RECONDITIONING
Do you have sexual difficulties? Are you satisfied with your sexual life?
A couple achieves sexual satisfaction when they enjoy emotional and physical intimacy during sex. Sexual frustration occurs when difficulties emerge to inhibit the female sexual response. Female sexual difficulty often expresses as low sexual desire/interest, inadequate subjective sexual arousal, defective genital sexual arousal, delayed or inability to reach orgasm, painful sex and failure to consummate.
Female sexual dysfunction is a very common condition. 40-50% of women of all ages suffer one or more forms of sexual disorder. A recent large study in the Flanders illustrated the prevalence patterns of the various sexual difficulties.
20% to 30% of adults complained of the lack of sexual desire. Younger adults (30 to 44 years old) appeared to be more distressed by it than those who are older (50+ years). The physical changes of pregnancy, childbirth and breastfeeding, and the stress of early motherhood and career building are probable causes.
The prevalence of lack of subjective arousal increased from 10% at 30 to 34 years, to 25% at 70 to 74 years, and the women generally become more distressed by it with advancing years. One explanation may be the rising burden of medical illness with advancing years, such as hypertension and diabetes.
Do we need a “good” sexual life?
Sexual connection within a relationship serves to bring the couple together, not just physically for procreation or satisfaction of needs, but also emotionally.
Thus, impaired sexual function not only vitiates the woman’s quality of life but also damages that of her partner/ family. The crippled female sexual function can also affect her productivity, weaken her psychological health, and upsets both interpersonal and intrapersonal stability.
It is imperative that women seek “good” healthy sexual lives. Having an intimate sexual relationship will not only gratify her life quality, it will promote communication with her partner, build up the family and mitigate community breakdown.
Female sexuality is negatively affected when one or more of several areas, including biological, psychological, social, medical and relational aspects, are undermined. Couples with sexual difficulties often accommodate their sexual underperformance for years, allowing the relationship to decay irreparably. Sadly, only 15% women who suffer female sexual dysfunction seek help.
Progression of sexual dysfunction
Absent or delayed orgasm manifested more in the early adult years (younger than 30), least in middle years (between 40 and 50) and become more prevalent again in the older years. The psychological pressure at sexual coming-of- age and the lack of experience may be the reason for the young women to have more orgasmic failure.
Painful sex (dyspareunia) is more common for young women (under 30) and older women (above 50) than middle-aged women. Sexual inexperience, strong perineum and gynaecological disorders contribute to painful intercourse in young adults. Vulvar vaginal atrophy and dermatological lesions in the menopausal years cause pain during intercourse.
Generally, all types of sexual difficulties are more likely to occur as women age. However, it is younger women who are usually distressed – what is crucial is whether they acknowledge it and seek solutions.
Managing female sexual difficulties and dysfunction
Managing female sexual difficulties and dysfunction requires a multi-faceted approach. It begins with a thorough evaluation of the sexual difficulty, a measurement of the extent of its impairment, and an understanding of the multi-play of different causative factors.
Where there is no organic aetiology, the focus will be on counselling and psychosexual therapy. Where there are hormonal or medical contributions to the sexual disability, the judicious application of physical treatment, mechanical devices, and pharmacological formulations becomes necessary.
Non-surgical, Safe Energy-Based Procedures to Enhance Sexual arousal
Vaginal reconditioning reinvigorates female sexual function. This far-reaching development opens up new avenues to treat sexual arousal, orgasmic and sexual pain disorders.
Laser and radio-frequency waves are harnessed to heat up vaginal connective tissue, which ultimately results in elasticity restoration. Studies show significant improvement of vaginal laxity and sexual satisfaction (resumption of orgasm) after radio-frequency therapy. The latest randomised controlled study in 2017 found a single radiofrequency treatment using restored 44% of women who presented with vaginal laxity (Viveve I Trial). Both CO 2 and Erbium-YAG lasers have proven to be efficacious to reduce vaginal dryness, thereby relieving dyspareunia.
These procedures are non-invasive, and there is no post procedure downtime. The side effect profile is extremely favourable, with merely occasional minimal skin irritation after the laser treatment. Women tolerate the procedures very well.