Menopause marks the end of a woman’s menstrual cycles. For some women, this means the end of uncomfortable period symptoms like menstrual cramps, bloating and mood swings. However, menopause can lead to a new set of symptoms like hot flashes and changes in the genital tissues that can involve discomfort related to dryness, more frequent vaginal and urinary tract infections, painful intercourse, pelvic issues and some urinary leaking with exercise or coughing. The longer a woman is menopausal, the vaginal tissues become thinner, drier and more easily irritated, and the area experiences pH changes. These changes are common in menopause and sometimes occur in perimenopause, or during the transitional years before a woman stops having cycles.
However, there is help: A treatment called ThermiVa is a non-invasive vaginal procedure that can help treat some of the symptoms associated with perimenopause and menopause. We talk to the professionals at Mestemacher Clinic for Women — Dr. Christine Mestemacher, Dr. Yvonne Moore and Leslie Norman, Women’s Health Nurse Practitioner — as well as patients who have experienced the brave new world of ThermiVa to find out about this impactful treatment that can help ease the symptoms associated with these common age-related changes.
First, a few words about perimenopause and menopause. Perimenopause may happen 10 years before a woman stops having periods and presents with fluctuations in hormones. “It takes years to start having a period, and it takes years for your body to unwind [from having a period],” says Dr. Mestemacher about perimenopause. However, a woman isn’t technically menopausal until she been without a period for a year. The average age of menopause is 51.
Mestemacher Clinic began offering ThermiVa in Fall 2018. The process begins with potential patients scheduling a consult with the clinic to discuss personal goals and to make sure everyone — doctor and patient — is on the same page about expectations. “Some patients have dribbling when they run, and ThermiVa can help with that issue,” says Dr. Moore. Women also seek out the procedure to combat painful intercourse that can be associated with the thinning of the tissue, or atrophy, in the genital area that can occur during menopause. ThermiVa is one of many tools that can be used to combat menopause symptoms related to atrophy. “There are creams and other treatments that can help manage the atrophic changes,” explains Leslie Norman. The Mestemacher Clinic also recommends pelvic floor physical therapy for urinary incontinence, and medications for vaginal dryness for some patients. Thermiva can be used to boost the effects of some of those treatments, or it can be used alone.
There is sometimes a lack of dialogue about menopause, and the changes that come with it. According to Dr. Mestemacher, “Women are often relieved to know that they are not the only ones with these issues, and that there are options.” The clinic also encourages women to talk to their partners about the changes in their bodies. “When women come in complaining of vaginal atrophy, which can lead to issues in the bedroom, I show them a handout about it and encourage them to take it home and show it to their husbands,” says Dr. Moore.
ThermiVa is ideal for women who can’t or don’t want to use estrogen or medications to treat menopause, because they have had breast cancer or are at risk for breast cancer. Additionally, there are some contraindications to the procedure, such as a pacemaker or Paragard IUD.
ThermiVa uses radiofrequency energy to gently heat the tissue to rejuvenate collagen in the vagina. The process takes three sessions, each lasting 30-40 minutes. The sessions are scheduled 4 to 5 weeks apart, and the results last for about a year. Using a heated wand, doctors treat the outside of the vagina, the labial folds and inside of the vagina (but not the cervix). ThermiVa uses the same technology that is used to build collagen in the face or to tighten other parts of the body. Patients can read or listen to music during the procedure and can notify the provider if they are experiencing discomfort. Before the procedure, patients must be fully hydrated and shave the vaginal area in order to better tolerate the heat. After the session is done, there is no downtime — patients can even have intercourse after the first treatment, which actually stimulates blood flow to the treated areas. “Some patients like to see before and after pictures, but many benefits from ThermiVa are not necessarily visible,” says Leslie Norman. She encourages patients to watch YouTube videos about the procedure if interested before coming in for a session.
ThermiVa does not require a prescription, and it is non-surgical. However, the treatment costs $2,400 and is not covered by insurance. However, the providers believe that ThermiVa can be part of one’s personal wellness regime. “There are many things that we do that help us feel better about ourselves, promote our health, and increase our sense of wellbeing that are not covered by insurance,” offers Dr. Moore.
Although results depend on the person, the overall patient feedback has been positive. “I’ve been very pleased,” says Judy, whose last name is being withheld for privacy. Prior to treatment, Judy experienced issues with urinary leaking, and a doctor friend told her about ThermiVa. “It did a great job, and there wasn’t any discomfort at all,” she adds. Plus, she likes that the procedure is less invasive than other treatments.
Another patient who benefitted from ThermiVa is Diana, who sought out the treatment to help with painful intercourse. She also experienced leaking while exercising and sneezing. “No amount of moisture can fix a thinning wall, and at my age, no amount of kegels can fix the atrophy. I couldn’t be more pleased with the results,” she says. “I couldn’t recommend it enough. It’s now part of my self-care plan.”
As you encounter the normal effects of aging, ThermiVa is one tool that can help with the transition through menopause and the changes it brings. To learn more about ThermiVa and if it’s the right treatment for you, contact the Mestemacher Clinic for Woman at (901) 624-4444 or visit mestemd.com.
This article is sponsored by the Mestemacher Clinic for Women. All photography provided by the Mestemacher Clinic for Women.