Turning Back The Mileage
BODY & SOUL
V-juvenated! The new £3,500 treatment that has changed my life
She’s had two children and has hit the menopause with all its discomforts. Here, Kate Thomas, 50, describes what happened on a visit to a leading gynaecologist
Tania Adib is chatting away, practical and relaxed, as if all this were perfectly normal. But then for her it is. She’s a gynaecologist. I’m sitting opposite her in one of those chairs with my legs up and apart and my pants off, feeling all sorts of awkward. Yes, I’ve had smear tests, but I have never been to a gynaecologist before, let alone one who is going to have a go at rejuvenating my vagina with a long, slim probe.
The only thing protecting my modesty is a small towel draped across my lower tummy. Oddly it helps, because I don’t have to watch her burrowing about in my denuded pubic area — shaved this morning because the treatment demands it and I hadn’t booked into my local waxing parlour in time. Who knew it would be back-to-back with Hollywood waxes on a Monday? But I digress.
Adib is tall, composed and smartly dressed, with long tawny hair and a low-key, respectful manner. As a consultant gynaecologist working privately (the Lister) and in the National Health Service (Queen’s Hospital, east London), she specialises in treating gynaecological cancers and the menopause and sits on the board of the Breast Cancer Haven charity.
She explains that the probe machine, the ThermiVa, uses radio frequency, a kind of energy derived from radio waves. It will heat up the skin tissues lining the vagina to 45C or 46C, enough to make the collagen in those tissues contract and tighten. It will also make the walls of the vagina grow new collagen and elastin to make them strong and springy and improve the blood supply and production of the vaginal fluid without which sex, post-menopause, can be so painful. She’s mainly using it on menopausal women and says it’s great for vaginal dryness and mild stress incontinence, but that it’s also great for younger women to counteract the stretching during childbirth. In either case, it’s restoring vaginal health.
My mind is buzzing with anxiety and barely takes all this in as Adib picks up a long white probe, which is attached by a cable to a tall machine at my side. She asks her nurse for a huge syringe of conductive gel, squirts it neatly inside me, gently inserts the probe and starts to move it carefully and methodically around.
I brace myself to wince, but it feels like . . . nothing. But then I can’t feel much on my insides, and that’s one of the reasons I’m here. That and my pelvic floor, which lets me down now and then, as it did in a boxing class the other day. We had to skip with ropes, bouncing with both feet together, and I barely realised what was going to happen before I sprang a leak.
When I told this to my friend Jo, she said I should see Adib. Jo has a job that means she’s up to speed on all the latest procedures and she’s had ThermiVa — of course she has. And she rates it. She has shocked me in the past with talk of the “designer-vagina” trend and the labia trimming and hymen rebuilding that goes with it, and I’ve tut-tutted. Who would do that? What kind of cultural pornification has taken place that women feel their lady parts have to conform to some plastic ideal?
But what’s going to be really huge, Jo tells me, is non-surgical “intimate rejuvenation”, as it is coyly called. Things such as this ThermiVa, which tightens everything up, including your pelvic floor, improves your sex life, takes less than an hour and doesn’t hurt. She says that half the Botox clinics in London are offering it — discreetly, because it’s a bit of a leap from wanting to soften your wrinkles to deciding to get your ya-ya lasered — and that at the sort of conferences she goes to every brand that makes machines that de-age the face now has something to offer for the vulvo-vaginal region.
I want to denounce this as disturbing, but I’m intrigued, if confused. Is this intimate “work” being done for aesthetic reasons or for improved v-health? And do you really want a Botox nurse zapping your hooty-hoo? At any rate, I’m glad I’m in Adib’s gynaecologically trained hands. She does the treatment at a cosmetic clinic too, although it’s one of the smartest: the slickly designed Mallucci London, tucked away in a cul-de-sac off Brompton Cross, in Kensington, London.
I couldn’t care about the aesthetics of my undercarriage, but then I’m 50, tipping into the menopause and my husband, bless him, really doesn’t care what my downstairs looks like as long as he can gain regular access. But treating vaginal laxity — that’s the technical term for looseness — sounds interesting. Way back when, nearly 20 years ago, I had two enormous babies, which must have stretched everything out, I have never been able to forget one of Martin Amis’s characters [in The Rachel Papers] describing sex with a woman who has given birth as like “waving a flag in space”. My husband nobly says it’s not, but I bet it is.
Adib tells me I have only a mild degree of laxity, not a patch on some of the women who seek her help. Her background is as a consultant in gynaecological cancer and the surgery that goes with it, and that has made her concerned about the knock-on effects of menopause, which the surgery would often bring on, sometimes suddenly.
“We cure women of cancer, but it is the long-term effects that they have to cope with,” she says. “Women who have had breast cancer also struggle with vaginal dryness, and this is a great treatment for them. Other women choose not to have hormone replacement therapy for other reasons, but want an effective and reliable treatment for vaginal dryness, which unfortunately tends to get worse with time.”
She set up a menopause service for her patients, looking at what could be done to help through diet, mindfulness, juicing and sprouting — “I’m half-German,” she says, laughing; “I like all that complementary stuff” — and at a gynaecological conference two years ago spotted a laser device offering non-hormonal treatment of vaginal dryness, with decent scientific data to validate its effectiveness. This was — don’t snigger — MonaLisa Touch, a laser device that she still uses for treating vaginal atrophy, the dryness that sets in once the body’s supply of oestrogen dries up at menopause.
When she started consulting at Mallucci London last year the clinic suggested she use the ThermiVa. “So I got trained and I just love it,” she says. “The laser is great for atrophy, but radiofrequency is better for laxity and fantastic for atrophy too.”
After that first session I spend the rest of the day in a shaky daze. Not because anything hurt; I just can’t believe I have done this. But I am cautiously hopeful because it feels as if something has been suctioned back up inside me.
Actually I know there is shrinkage because zapping the vulva — that’s everything on the outside of the vagina — is part of the treatment, and Adib took pictures of my labia before and after (I can’t believe I just typed that, and no I don’t have a copy on my phone. Nor does she — they’re hidden on an encrypted area of her iPad). It did feel a bit hot as she skated the probe around, but she turned down the temperature until it was bearable. “But look at the difference,” she said enthusiastically. I wanted to shut my eyes — this is all so . . . very unusual — but could see that the loose flappy bits had shrunk and neatened. “Yes,” she said, “and that is what will have happened on the inside too.”
Good grief. Can this machine do this on the face? It would clean up! Up to a point, she told me. The face tissues aren’t hanging so loose.
A month later I return for a second session. Adib asks how I’ve felt and, well, I’m not sure what is different during sex, nor is my husband. I didn’t tell him that I’d had a treatment until he asked when I was going to go and I said I’d already been. Then he claimed he could tell. Hmm. “That’s quite typical of men,” Adib says.
But I’ve been skipping secretly in the kitchen and I can get up to 40 bounces before my pelvic floor feels the stress, so something must be happening.
How does it work on the pelvic floor? Actually, Adib tells me, it doesn’t, because the pelvic floor is muscle, But ThermiVa works on the soft tissues of the vagina and strengthens and supports them — tightens them, makes more collagen and elastin, grows more blood vessels — in a way that no exercise is going to do, and that is what helps to fix stress incontinence and that sort of urgency to wee that can affect many post-menopausal women. Do your pelvic floor exercises, the good old pull-up-and-hold sort that are taught to mums-to-be, alongside treatment and you’ll be laughing, even if you sneeze.
But by the third session — for best results you need a course of three treatments, each a month apart, to boost that growth of collagen and all the rest — I can tell there is a definite change going on inside me. Sex is less flag-in-space; more of a snug fit. My pelvic floor feels as if it has, as one of Adib’s other patients put it, “gone up a floor in the lift”.
I like Adib enormously and am thrilled by the way she gets fired up when she talks of her crusade to improve our v-parts and all the issues that we are too embarrassed to discuss. “I know lots of aesthetic clinics are using it,” she says, “but it’s actually about improving vaginal function. Vaginas are not just passive organs; they’re very dynamic. They contract when you become sexually aroused, they produce secretions, and the health of the vagina determines the health of the bladder and the bowel. When you get vaginal atrophy, you get dryness, discomfort, itching, burning, recurrent vaginal infections and urine infections. Maintaining the health of the vagina is underrated and it’s so important for women’s sexual and general wellbeing.”
She and her magic wands are at the forefront of this new wave of treatments and the buzz around them is building. Tatler has mentioned her work, although most patients simply arrive by word-of-mouth recommendation. “I haven’t had anyone who hasn’t been delighted,” she says.
Not everyone likes it, however. Most gynaecologists, wary after the recent debacle over the use of surgical mesh to treat prolapses in the vagina, take the view that there are no randomised controlled trials around ThermiVa and MonaLisa Touch, and are concerned about potential future problems.
“There is no evidence to suggest that non-surgical devices are effective in improving vaginal muscle tone or treating vaginal dryness,” says Dr Vanessa Mackay, a spokeswoman for the Royal College of Obstetricians and Gynaecologists. “If women are concerned about the appearance or feel of their vagina, they should speak to a healthcare professional.”
Yet those who use it and have tried it love it. Certainly the reviews on RealSelf, a US-based website where people post queries about surgical and non-surgical procedures, are largely ecstatic. (Watch out, if you are moved to take a look. The pictures are graphic. Labia, I now realise, come in every shape and size.) I also read with interest that there is a study showing that this treatment can help women who can’t reach orgasm. Maybe by reviving nerves in the vulvo-vaginal area. And as for my own? Maybe it’s suggestion, maybe it’s for real, but they’re better. It’s a bit, I thought while watching the Winter Olympics, like a ski jump. Sometimes you barely make it to the lip of the jump and just subside. But other times you take off and soar. Well, I’m soaring.
For Adib this is the tip of the iceberg. She’s championing women’s sexual function and enjoyment into their old age. “That’s what I really want to see,” she says. “That women can have a satisfying sex life way into their seventies and eighties. And it is treatments like this that will enable that.
“There’s a big regenerative movement coming. Medicine is moving on. It’s so exciting. No longer does it have to be just drugs or surgery — there’s all this other stuff.”
For now there’s laser and radio frequency treatment, which needs a top-up each year to stay effective, but she’s also about to be trained in how to inject the vagina with cells taken from a patient’s fat. It’s a one-off treatment and she will be the first to offer it. I’m fine for now, thanks, but in due course? I’ll be first in line.
ThermiVa with Tania Adib costs £3,500 including gynaecological consultation, smear, scan and six-month review at mallucci-london.com
ThermiVa with Tania Adib costs £3,500 including gynaecological consultation, smear, scan and six-month review at mallucci-london.com
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