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Technological Advances in Urogenital Health

VAGINA, VAGINA, VAGINA!!!

Everyone should be comfortable saying this word. Unfortunately, 77% of woman struggling with symptoms of urogenital atrophy (a.k.a. Genitourinary Syndrome of Menopause) are reluctant to discuss their symptoms with their doctor because they think ‘it’ is a taboo topic.  Women are often embarrassed to report their experience to their doctor believing their symptoms will “clear up” on their own.  And, to make matters worse only 7% of healthcare practitioners are initiating the conversation about urogenital health.

This reluctance to talk about ‘it’ is a major barrier that often prevents woman from accessing safe and effective treatments. 

So, Let’s Talk About ‘It’!

Urogenital atrophy can present with one or a combination of many symptoms that include vaginal dryness, painful intercourse, recurrent bladder infections, a ‘leaky’ bladder, urinary urgency, frequency of urination or decreased sexual desire, diminished arousal or intensity of orgasm.  ‘It’ is a common problem affecting 45-55% of midlife and older woman.

By the year 2025, an estimated 1.1 billion women over the age of 50 world-wide will struggle with any one of these symptoms of urogenital atrophy!!

That’s astonishing!

What is most upsetting is that 75% of woman who suffer with these symptoms report a negative impact ­­on their sexual life and 33% felt it had a negative impact on their marriage or relationship…so, this isn’t just a woman’s issue it’s a couple’s issue!

What a shame when it doesn’t have to be this way!­­­

Here is a list of everything you need to know about urogenital atrophy (UGA); the medical condition that your vaginal and bladder symptoms are indicative of.

  1. UGA is caused by hormonal imbalances related to the transition to menopause. Urogenital atrophy is the medical term used to describe the thinning tissues of the vagina and vulva that can happen with the dwindling levels of estrogen that occurs with peri-menopause and menopause. Most women who experience vaginal irritation and bladder leakage symptoms as a result, don’t realize they are linked to menopause. Some women experience the same symptoms as a result of a hysterectomy or breast cancer treatment, both of which cause similar hormonal imbalances.
  2. It is extremely common. Many peri-menopausal and almost all postmenopausal women experience some form of UGA. Vaginal and bladder symptoms are natural and are faced by most women as they age.
  3. It is a chronic, progressive condition. Because the root cause of UGA symptoms is hormonal, they are likely to worsen and won’t “clear up” over time. If left untreated, the condition will continue to progress and can intensify.
  4. It requires medical attention. UGA symptoms should not be left untreated. If you are experiencing any of the symptoms mentioned above, do not suffer in silence! Do not put off seeing your doctor and make an appointment to have them addressed.
  5. Extremely effective treatments are available.  And finally, here’s the good news. There are new treatments available now that are revolutionizing the way doctors treat UGA. They have been shown to reverse symptoms and return women’s lives to normal. And unlike treatments in the past, they are generally safe, painless and non-invasive.

Treatment Options Available in Canada…

… that women are calling “life-changing”. Woman initially try lubricants, vaginal moisturizers and in many cases hormone replacement therapy. These approaches may have worked at first but often the symptoms get to the point where many women are bothered enough to seek a different approach.

CO2 Fractional Laser Therapy (MonaLisa Touch®)

For decades, the medical community has used lasers for various conditions but most notable has been the facial resurfacing CO2 fractional lasers. This same technology is now being used for treatment of urogenital atrophy of the vagina/vulva and with tremendous success. CO2 fractional laser therapy is revolutionizing vaginal health and consistently provides great results that have been profound for many patients. The principle of this treatment is the laser stimulates the body to heal itself. Studies show that the laser causes re-vascularization, re-collagenization, re-keratinization, improved elastin and glycogen production as well as returning the pH back to normal range. The treatment typically includes three quick five minute in-office treatments six weeks apart. It does not require anesthesia and there’s no downtime. MonaLisa Touch® laser therapy has been shown to provide overwhelmingly positive results and symptom relief.  This series of treatments allows for significant or complete relief of symptoms including improved bladder control, increased vaginal lubrication and improved sexual function for approximately one year, after which another single treatment session may be recommended. The cost for the initial series is approximately CA $2,000.00.

Electro-Magnetic Therapy (Emsella)

Emsella is a non-invasive, painless, ‘clothes-on’ procedure that creates the equivalent of 11,800 supra-maximal pelvic floor contractions (Kegel) in a 30 minute session. You can imagine how strong the pelvic floor muscles would be after six sessions (two per week)!  Electromagnetic therapy re-educates the muscles of the pelvic floor and therefore improves urinary incontinence and quality of life in 95% of patients. A series of six treatments is approximately CA$1800.00.

Photobiomodulation Therapy (vSculpt ®)

vSculpt® is a non-invasive, light, heat and vibratory-energy-based, in-home treatment device that stimulates muscle, and connective tissue cells resulting in improved bladder control, increased vaginal lubrication and sensation, overall toning, tightening of the pelvic floor muscles and improved sexual function. vSculpt® is a safe, affordable and effective treatment that can be used alone or in conjunction with other modalities. The cost is approximately CA$500.00.

Sound Wave Therapy (Cliovana)

Cliovana is a simple, non-invasive treatment using sound wave technology to enhance orgasms at a cellular level. The four treatment series boosts the process of regenerating vasculature and nerves in the genitals resulting in improved blood supply to the clitoris. This mechanism is key as the clitoris has 8,000 nerve endings (double the number in the head of the penis) and is essential to overall sexual satisfaction for most women. This regeneration results in a long-term clitoral responsiveness which can lead to consistently increased arousal and more frequent and powerful orgasms. The cost for the initial series of four treatments is CA $2,000.00.

Don’t suffer in silence…speak up, knowing there is help!

 References

Vaginal Health: Insights, Views and Attitudes (VIVA)-results from an international survey; Climacteric 2012 Feb;15(1):36-44.

Wysocki, S., Kingsberg, S., & Krychman, M. (2014). Management of Vaginal Atrophy: Implications from the REVIVE Survey. Clinical Medicine Insights: Reproductive Health, 8. doi:10.4137/cmrh.s14498

Kim, H. et al. The Recent Review of the Genitourinary Syndrome of Menopause. J Menopausal Med. 2015 Aug: 21(2):65-71. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561742/

About The Author

Dr. Kristy Prouse, MD, OBGYN, FRCSC earned her medical degree at Queen’s University and completed her obstetrics and gynaecology training receiving Laparoscopic Surgery Award of Excellence. She has done additional training in Anti-Aging and Regenerative Medicine through the University of Southern Florida – School of Medicine and has practiced obstetrics and gynaecology for over a decade in the greater Toronto area. In addition to running her busy practise, Dr. Prouse sits on the editorial review board for Integrated Healthcare Practitioners journal and is associate professor at the University of Toronto.

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