When you think of aging, wrinkles and jowls likely come to mind. However, the effects of time reach much further than the skin on our face. Some women experience changes to their most intimate areas, which can lead to issues like dryness, incontinence, and painful intercourse. The good news is that these changes can be effectively addressed through non-surgical procedures, improving the quality of life for many women today. 

Leysin Fletcher, PA-C discussed this issue in her April webinar, Vaginal Rejuvenation. During the session, Leysin introduced the non-surgical treatments that can reverse changes in the vagina, improving both appearance and function. To check out her webinar, click here

The Changing Vagina

The menopausal years are often the time when women start to experience noticeable changes to the vagina and labia, due to decreased estrogen production. These changes might include: 

  • Thinning tissue
  • Reduced lubrication
  • Shortening of the vaginal canal
  • Loss of elasticity 
  • Laxity and sagging labia

These changes can lead to painful intercourse, reduced sexual enjoyment, and uncomfortable dryness. Laxity of the muscles and tissue can also create urinary incontinence or a leaky bladder. Leysin explains that with the appropriate treatment, the challenges women face during this time can be greatly alleviated through rejuvenation of the area. 

Leysin talked about two devices used at Cosmetic Laser Dermatology in San Diego for vaginal rejuvenation. Both treatments are non-invasive and can bring significant relief to women suffering from the effects of a changing vagina.

thermiva vaginal tightening treatment in san diego, caThermiVa

ThermiVa is a device that utilizes radiofrequency energy to gently heat the tissue and stimulate new collagen growth. The treatment also improves blood flow. Benefits of ThermiVa include: 

  • Tightening of the vaginal canal and enhanced lubrication
  • Improvement in urinary incontinence or a leaky bladder
  • Improved aesthetic appearance of the external genitalia
  • Enhanced sexual pleasure by improving sensitivity

ThermiVa is a painless office treatment that takes just 30 minutes to complete. The first 15 minutes focus on the external genitalia and the second half of the procedure treats the vaginal canal and bladder wall. The wand used for the procedure is about the size of the index finger and is designed for comfort as it delivers gentle heating to the treatment area. 

There is no downtime after a ThermiVa treatment. Patients can even engage in normal sexual activity immediately following the procedure. You may notice improvement right away, but results will continue to improve 3-6 months after the procedure. 

Leysin recommends booking three treatments at monthly intervals to achieve the full effect. At that point, a single treatment every 8-12 months should help you maintain your results. 

Proven Treatment

In 2018, Dr. Goldman and Dr. Wu from Cosmetic Laser Dermatology in San Diego participated in a clinical study to examine the benefits of ThermiVa treatments. They evaluated 10 female subjects to determine whether ThermiVa was effective in treating vulvovaginal laxity, atrophic vaginitis, orgasmic dysfunction, and stress urinary incontinence. 

The researchers found that after three treatments, spaced four weeks apart, subjects experienced significant improvement in vulvovaginal laxity and atrophic vaginitis, as well as sexual satisfaction. More modest improvements were seen in orgasmic dysfunction and stress urinary incontinence.


Viveve is the second vaginal rejuvenation treatment offered by Cosmetic Laser Dermatology. This device uses cryogen-cooled radiofrequency energy to gently heat the vaginal tissue. The cryogen helps cool the surface of the skin to more effectively deliver heat to the targeted tissue to produce more collagen growth. 

Benefits of Viveve include: 

  • Tightening of the vaginal canal
  • Stabilizing the bladder wall to improve urinary incontinence
  • Enhanced blood flow to improve lubrication

Patients only need one 30-45 minute session of Viveve to enjoy the full effects of the treatment. However, results do not appear immediately it takes 1-3 months for them to fully take effect. Once they do, you can maintain results with an annual session or a touch-up treatment when you notice your symptoms returning. 

Like ThermiVa, this procedure does not involve any downtime, and you can resume normal sexual activity right away. 

Viveve has also been examined in clinical studies. Leysin cited a 2017 study that found Viveve was effective in improving sexual function and vaginal laxity. Both devices have been determined to be both safe and effective as vaginal rejuvenation treatments. To learn more about vaginal rejuvenation, visit pubmed.gov

Candidates for a Vaginal Rejuvenation Treatment

Leysin explains that women might be a candidate for vaginal rejuvenation if they answer yes to any of the following questions: 

  • Have you experienced vaginal childbirth? Would you like to tighten the vaginal canal?
  • Do you feel loose during intercourse?
  • Do you leak urine when exercising, coughing, or sneezing?
  • Do you feel like the external appearance of the labia is not what it used to be?
  • Are you experiencing painful intercourse or dryness?
  • Would you like to improve intimacy and sensation?

Getting Ready for Vaginal Rejuvenation Treatment

Leysin recommends the following steps if you decide to move forward with one of these vaginal rejuvenation treatments:

  • Bring a copy of your normal pap results within the last 3 years
  • Come in with a clean shave
  • Make sure you have no presence of an IUD (except Morena)
  • Do not have any electrical devices (pacemakers, defibrillators)
  • Do not have any mesh exposure
  • Be at least 6 weeks post-partum if you recently had a baby

It’s Time to Talk About it

Vaginal rejuvenation is not something women are typically comfortable discussing. Instead, they often live with the changes even if they affect their quality of life. Leysin encourages women to talk to their doctor if they are experiencing issues, because effective treatments are now available.

If you would like to learn more about your options in vaginal rejuvenation, contact San Diego’s Cosmetic Laser Dermatology today.


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