Time affects femininity

Different ages of a woman’s life are accompanied by different experiences with regard to her intimacy and her sexuality, and are unavoidably associated with a variety of vaginal conditions. These may strongly affect the quality of life of a woman, both physically, psychologically as well as sexually. Childbirth (especially natural) and menopause are just two examples of events that cause a change in the intimate area and vaginal environment, each of them accompanied by different disorders.
Many women who experience unpleasant symptoms such as genital itching, irritation, poor vaginal lubrication, vaginal dryness and even pain during intercourse (dyspareunia) do not like to talk about these issues, sometimes not even with their gynecologist. They can be ashamed and think that they are the only ones going through these issues. In fact, all of these symptoms are quite common in women of different ages and tend to worsen over time. That means that they are not temporary and they are not going to disappear if not treated.

Vaginal Relaxation Syndrome (VRS)

A quite common condition usually associated with vaginal child birth as well as with natural ageing is Vaginal Relaxation Syndrome (VRS), a condition described as a loss of the optimum vaginal structure. Pregnancies and births contribute to a worsening of VRS condition, as does the onset of menopause, which causes a decline in hormone levels and vaginal atrophy. Most women (and their partners) refer to vaginal relaxation syndrome as “enlarged vagina”, complaining of a loss of vaginal tightness, which is directly related to the reduction in friction during intercourse and thus to a decrease or loss of sexual gratification.

Stress urinary incontinence (SUI)

Stress urinary incontinence (SUI) is also a quite widespread disease prevalent in women after their first birth (between 24 and 29 % of women suffering from this condition). It is a form of urinary incontinence caused by a loss of support of the urethra, which is usually a consequence of damage to pelvic support structures as a result of childbirth. Similarly, frequent exercise in high-impact activities can cause athletic incontinence to develop. In both cases, it is characterized by the leaking of small amounts of urine during activities which increase abdominal pressure such as coughing, sneezing and lifting weights.
Women with stress urinary incontinence have an altered connective tissue metabolism, which causes decreased collagen production and which may result in insufficient support of the urogenital tract.

Vaginal Atrophy

Finally, there are a number of symptoms experienced by women undergoing menopause (normally between 45 and 55 years of age), including vaginal dryness, itching, painful intercourse, poor lubrication, decreased libido and poor vaginal muscle elasticity and tone. This condition is also described as vaginal atrophy and it follows a reduction in the production of estrogen by the ovaries. It involves the gradual thinning of genital epithelial tissues, vaginal and vulvar mucosa, which reduces thickness and becomes more fragile, irritable and sensitive to trauma.
Most physical and mental changes occurring during menopause can impact the quality of sexual life in a relationship.

Mini-invasive treatment options

Until recently, all these conditions were considered to be a consequence of the inevitable ageing process of the woman, and treatment was undergone only in very rare cases where serious medical conditions were recognized (e.g. prolapse). The traditional surgical or pharmacological responses represent a very invasive solution to these problems, with a high risk of side effects including wound disruption, dyspareunia, postoperative bleeding or fistula formation.
Today, an increasing number of women are becoming aware of the possibility to improve the tone and functionality of that particular area, and consequently their quality of life, with minimally invasive procedures, such as the Juliet treatment by Asclepion.
The Juliet laser treatment is performed using an Erbium:YAG laser and represents a fast, painless and discreet treatment with very low risk of side effects and minimal down-time.
The main mechanism of action of Erbium:YAG technology is to achieve the selective stimulation of the synthesis of sub-mucosal collagen, leading to an improvement of the tissue and a restoration of its original metabolism.

Ablative lasers: the gold standard for dermatological treatments

The ablative lasers are the “gold standard” of lasers for dermatological treatments. They ablate the skin with a degree of precision that can be measured in microns. This makes it possible to safely and gently remove a wide variety of lesions from the skin at epidermis and dermis level. Due to their ease of absorption in water, both the Erbium:YAG (2,940 nm) and the CO2 (10,600 nm) wavelengths are highly suitable for this purpose.
The skin is disinfected before the treatment is carried out. Then, depending on the size and/or depth of the lesion to be dealt with, the dermatologist decides whether anesthesia is required and what type of anesthesia is appropriate (most of the treatments are very well tolerated without any anesthesia!).

Gentle and effective treatments

Treatments using lasers are gentle on the skin and eliminate bothersome skin lesions very effectively and in a matter of minutes. The Erbium laser works very precisely and can selectively remove skin areas to a predefined depth with little pain. At the same time it stimulates skin renewal. The results are impressive: tangibly smoother, softer skin.
After treatment, it normally only takes a few days for the wound to heal. It is recommended not to expose the treated area to sunlight or sunbeds for at least 10/15 days prior to/following treatment. The use of sunscreen is recommended in summertime and in general when treating areas exposed to sunlight (e.g. the face).
Studies show that the Erbium laser is also very effective in treating scars, for example acne scars, and for skin rejuvenation. The success results from the highly precise removal of tissue during treatment, softening and smoothing of tissue during wound healing and collagen neogenesis during the first year post-op.

What is the Juliet treatment?

Juliet is a minimally invasive vaginal rejuvenation treatment, the goal of which is to restore the original metabolism of connective tissue and improve the state of the mucosa, by stimulating a process of neocollagenesis. This leads to a restoration and a return to the natural PH of the mucosal structure, increasing its flexibility.

What does “vaginal rejuvenation” mean?

Vaginal rejuvenation is not intended to be just an aesthetic treatment. A Juliet laser treatment leads not only to a tightening of the internal vaginal walls (often referred to as “rejuvenation”), but it also involves specific functional changes, for example the regaining of functionality when treating for mild stress urinary incontinence and also the restoration of tissue metabolism in the case of vaginal atrophy.

How does the Juliet treatment work?

The wall of the vagina is composed of four different layers:
• Mucosa – Internal lining of epithelial tissue made up of squamous epithelial cells
• Sub-mucosa – Connective tissue that supports the mucosa and connects it to the muscularis
• Muscularis – Muscle tissue
• Adventitia – Connective tissue interlaced with elastic fibers, connects the vagina to surrounding organs

The vaginal walls are usually collapsed so that they touch each other. The walls have many folds, which allow the vagina to enlarge during sexual intercourse and childbirth. Glands near the opening of the vagina secrete mucus to keep the mucosa moist.
The objective of the laser treatment is to reach the sub-mucosa, which is elastic and rich in collagen and can be stimulated “selectively”, meaning without damaging the surrounding tissue. Thanks to the special characteristics of its wavelength, the Erbium:YAG laser is able to reach this goal in a very fast and effective way, avoiding unwanted side effects on the surrounding tissue.

What does the treatment involve?

The procedure is performed by a gynecologist or by a surgeon in a medical practice. Usually, no anesthesia is required (since neither incisions nor sutures are performed), however, a topical anesthetic may be applied if needed. Using the special V-Spot handpiece, the physician is able to perform the treatment in just a few minutes. The whole procedure takes less than 15 minutes and is fast, painless and discreet.

What should I expect from the treatment?

The Juliet laser treatment leads to a restoration of the metabolism of connective tissue and to an improvement in the condition of the mucosa. This translates into an attenuation of the symptoms which can be observed immediately after the first treatment. The inner mucosa regains elasticity and lubrication, gaining thickness and softness. Itching, irritation and pain during intercourse disappear and the symptoms of mild stress urinary incontinence are also significantly reduced as a result of the stimulating action of the laser on the mucosa. This action continues its beneficial effect even after the treatment is finished and, for this reason, many women report further improvements during the first month post-treatment.

Is the treatment painful?

No, the treatment is not painful at all. Usually, it is very well tolerated without anesthesia. If needed, a mild topical anesthetic may be applied.

How many sessions are necessary?

In most cases, satisfactory results can be obtained after the first session, with no need for further treatments. Depending on the severity of the symptoms however, a second treatment may be recommended after few months.

Which women can undergo a Juliet laser treatment?

In general, any women experiencing these symptoms and looking for a fast, non-surgical and discreet procedure can undergo a Juliet treatment. Before performing the treatment, your doctor will firstly rule out the presence of local or systemic diseases.

Are there any undesirable side effects?

No medical treatment is completely risk-free. Normally, this laser treatment has minimal complications. Potential side-effects can include an increase in temperature and febrile response in the first day following treatment and/or odorless vaginal secretions. These effects are temporary and usually disappear within one or two days.

How long is the recovery time?

The healing times are very short, normally no longer than three days. During this time, some secretion may be noticed (pink colored for the first day, then white colored). This is a normal reaction and will disappear in a few days.

What are the post-treatment instructions to be followed?

It is recommended for the first three days after the treatment to refrain from sexual intercourse, heavy physical exercise and sport activities such as swimming or sauna. Should a low grade fever arise, anti-inflammation is recommended (the symptom will in any case disappear after few days).

Asclepion Laser Technologies is working closely with physicians, clinics and universities to improve technologies to assess their effectiveness and safety as well as to improve its application. In clinical studies, scientific questions are answered in a controlled environment. This ensures the best possible results for both the users and patients.

Female intimate surgery: review of methods and Trends
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Professional therapy

With its extensive range of services, Asclepion sees itself as a competent partner for dermatologically and aesthetically oriented practices, institutes and clinics. Decide now for the treatment with the most advanced laser technology and discover a new world of professionalism and quality.