Urinary incontinence is leaking of urine that you can’t control. Many women suffer from urinary i­ncontinence. We don’t know for sure exactly how many. That’s because many people do not tell anyone about their symptoms. They may be embarrassed, or they may think nothing can be done. So they suffer in silence.

Urinary incontinence is not just a medical problem. It can affect emotional, psychological and social life. Many people who have urinary incontinence are afraid to do normal daily activities. They don’t want to be too far from a toilet. Urinary incontinence can keep people from enjoying life.

Many people think urinary incontinence is just part of getting older. But it’s not. And it can be managed or treated.

Key statistics

It is thought that urinary incontinence affects up to 37% of Australian adult women. Although it is commonly associated with pregnancy, childbirth and menopause, urinary incontinence affects women of all ages (although the prevalence increases with age) and is not restricted to women who have borne children – in fact, 12% of Australian women who have never had children and are aged under 30 have incontinence.

Studies show that many things increase risk. For example, aging is linked to urinary incontinence. Pregnancy, delivery, and number of children increase the risk in women. Women who have had a baby have higher rates of urinary incontinence. The risk increases with the number of children. This is true for cesarean section (C-section) and vaginal delivery.

Women who develop urinary incontinence while pregnant are more likely to have it afterward. Women after menopause (whose periods have stopped) may develop urinary incontinence. This may be due to the drop in estrogen (the female sex hormone). Taking estrogen, however, has not been shown to help urinary incontinence.

Obesity increases the risk of urinary incontinence. Losing weight can improve bladder function and lessen urinary incontinence symptoms.

What happens normally?

The brain and the bladder control urinary function. The bladder stores urine until you are ready to empty it. The muscles in the lower part of the pelvis hold the bladder in place. Normally, the smooth muscle of the bladder is relaxed. This holds the urine in the bladder. The neck (end) of the bladder is closed. The sphincter muscles are closed around the urethra. The urethra is the tube that carries urine out of the body. When the sphincter muscles keep the urethra closed, urine doesn’t leak.

Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract. This forces the urine out through the urethra, the tube that carries urine from the body. The sphincters open up when the bladder contracts.

What are the types of urinary incontinence?

Urinary incontinence is not a disease. It is a symptom of many conditions. Causes may differ for men and women. But it is not hereditary. And it is not just a normal part of aging. These are the four types of urinary incontinence:

Stress Urinary Incontinence (SUI)

With SUI, weak pelvic muscles let urine escape. It is one of the most common types of urinary incontinence. It is common in older women.

SUI happens when the pelvic floor muscles have stretched. Physical activity puts pressure on the bladder. Then the bladder leaks. Leaking my happen with exercise, walking, bending, lifting, or even sneezing and coughing. It can be a few drops of urine to a tablespoon or more. SUI can be mild, moderate or severe.

Ways to manage SUI include “Kegel” exercises to strengthen the pelvic floor. Lifestyle changes, vaginal and urethral devices, pads, and even surgery are other ways to manage SUI.

Overactive Bladder (OAB)

OAB is another common type of urinary incontinence. It is also called “urgency” incontinence. It affects people’s lives. They may restrict activities. They may fear they will suddenly have to urinate when they aren’t near a bathroom. They may not even be able to get a good night’s sleep. Some people have both SUI and OAB and this is known as mixed incontinence.

With OAB, your brain tells your bladder to empty – even when it isn’t full. Or the bladder muscles are too active. They contract (squeeze) to pass urine before your bladder is full. This causes the urge (need) to urinate.

The main symptom of OAB is the sudden urge to urinate. You can’t control or ignore this “gotta go” feeling. Another symptom is having to urinate many times during the day and night.

OAB is more likely in women after menopause. It is caused by many things. Even diet can affect OAB. There are a number of treatments. They include life style changes, drugs that relax the bladder muscle, or surgery. Some people have both SUI and OAB.

Mixed Incontinence (SUI and OAB)

Some people leak urine with activity (SUI) and often feel the urge to urinate (OAB). This is mixed incontinence. The person has both SUI and OAB.

Overflow Incontinence

With overflow incontinence, the body makes more urine than the bladder can hold or the bladder is full and cannot empty thereby causing it to leak urine. In addition, there may be something blocking the flow or the bladder muscle may not contract (squeeze) as it should.

One symptom is frequent urinating of a small amount. Another symptom is a constant drip, called “dribbling.”

This type of urinary incontinences is rare in women. It is more common in men who have prostate problems or have had prostate surgery.

Diagnosing urinary incontinence

If you experience urinary incontinence, see your specialist so they can determine the type of condition you have.

Urinary incontinence is a common problem and it’s likely your specialist has seen many people with the condition.

Your SPECIALIST will ask you questions about your symptoms and medical history, including:

  • whether the urinary incontinence occurs when you cough or laugh
  • whether you need the toilet frequently during the day or night
  • whether you have any difficulty passing urine when you go to the toilet
  • whether you are currently taking any medications
  • how much fluid, alcohol or caffeine you drink?

Bladder diary

Your SPECIALIST may suggest that you keep a diary of your bladder habits for at least three days, so you can give them as much information as possible about your condition. This should include details such as:

  • how much fluid you drink
  • the types of fluid you drink
  • how often you need to pass urine
  • the amount of urine you pass
  • how many episodes of incontinence you experience?
  • how many times you experience an urgent need to go to the toilet

Tests and examinations

You may also need to have some tests and examinations so that your SPECIALIST can confirm or rule out things that may be causing your incontinence. Some of these are explained below.

Physical examination

Your SPECIALIST may examine you to assess the health of your urinary system.

Your SPECIALIST will carry out a pelvic examination, which usually involves undressing from the waist down. You may be asked to cough to see if any urine leaks out.

Your SPECIALIST may also examine your vagina. In over half of women with stress incontinence, part of the bladder may bulge into the vagina.

Your SPECIALIST may place their finger inside your vagina and ask you to squeeze it with your pelvic floor muscles. These are the muscles that surround your bladder and urethra (the tube through which urine passes out of the body). Damage to your pelvic floor muscles can lead to urinary incontinence.

Dipstick test

If your SPECIALIST thinks your symptoms may be caused by a urinary tract infection (UTI), a sample of your urine may be tested for bacteria. A small, chemically treated stick is dipped into your urine sample. It will change colour if bacteria are present. The dipstick test can also check the blood and protein levels in your urine.

Residual urine test

If your SPECIALIST thinks you may have overflow incontinence, they may suggest a test called residual urine test to see how much urine is left in your bladder after you go for a wee.

This is usually done by carrying out an ultrasound scan of your bladder, although occasionally the amount of urine in your bladder may be measured after it has been drained using a catheter. This is a thin, flexible tube that is inserted into your urethra and passed through to your bladder.

Further tests

Some further tests may be necessary if the cause of your urinary incontinence is not clear. Your SPECIALIST will usually start treating you first and may suggest these tests if treatment is not effective.

Cystoscopy

A cystoscopy involves using a flexible viewing tube, known as an endoscope, to look inside your bladder and urinary system. This test can identify abnormalities that may be causing incontinence.

Urodynamic tests

These are a group of tests used to check the function of your bladder and urethra. This may include keeping a bladder diary for a few days (see above) and then attending an appointment at a hospital or clinic for tests such as:

  • measuring the pressure in your bladder by inserting a catheter into your urethra
  • measuring the pressure in your abdomen (tummy) by inserting a catheter into your bottom
  • asking you to urinate into a special machine that measures the amount and flow of urine

Non-surgical treatments for urinary incontinence

The treatment you receive for urinary incontinence will depend on the type of incontinence you have and the severity of your symptoms. 

Conservative treatments, which do not involve medication or surgery, are tried first. These include:

  • lifestyle changes
  • pelvic floor muscle training (‘Kegel exercises’)
  • bladder training

After this, medication or surgery may be considered.

Medication for Overactive Bladder

Anticholinergics

If bladder training is not an effective treatment for your urge incontinence, your GP may prescribe a type of medication called an antimuscarinic.

Anticholinergics may also be prescribed if you have overactive bladder syndrome (OAB), which is the frequent urge to urinate that can occur with or without urinary incontinence.

A number of different antimuscarinic medications that can be used to treat urge incontinence, but common ones include oxybutynin, and solifenacin.

These are usually taken by mouth daily, although an oxybutynin patch that you place on your skin twice a week is also available.

Your GP will usually start you at a low dose to minimise any possible side effects. The dose can then be increased until the medicine is effective.

Possible side effects of anticholinergics include:

  • dry mouth
  • constipation
  • blurred vision
  • fatigue

You will be assessed after four weeks to see how you are getting on with the medication, and every six to 12 months thereafter if the medication continues to help.

Your GP will discuss any other medical conditions you have to determine which anticholinergics are suitable for you.

Mirabegron

If anticholinergics are unsuitable for you (for example Glaucoma), or they have not helped your urge incontinence or have caused unpleasant side effects, you may be offered an alternative medication called mirabegron.

Mirabegron causes the bladder muscle to relax, which helps the bladder fill up with and store urine. It is usually taken by mouth once a day.

Side effects of mirabegron can include:

  • urinary tract infection(UTI)
  • High blood pressure
  • a rash

Your GP will discuss any other medical conditions you have to determine whether mirabegron is suitable for you.

Surgery and procedures for urinary incontinence

If other treatments for urinary incontinence are unsuccessful or unsuitable, surgery or other procedures may be recommended.

Before making a decision, discuss the risks and benefits with a specialist, as well as any possible alternative treatments.

If you are a woman and plan to have children, this will affect your decision, because the physical strain of pregnancy and childbirth can sometimes cause surgical treatments to fail. Therefore, you may wish to wait until you no longer want to have any more children before having surgery.

Surgery and procedures for stress incontinence

Tape procedures

Tape procedures can be used for women with stress incontinence.

A piece of plastic tape is inserted through an incision inside the vagina and threaded behind the urethra (the tube that carries urine out of the body). The middle part of the tape supports the urethra, and the two ends are threaded through two incisions in either the:

  • tops of the inner thigh – this is called a transobturator tape procedure (TOT)
  • abdomen (tummy) – this is called a retropubic tape procedure or tension-free vaginal tape procedure (TVT)

By holding the urethra up in the correct position, the piece of tape can help reduce the leaking of urine associated with stress incontinence.

The effectiveness of these tape procedures is similar, with around two in every three women not experiencing any leaking afterwards. Even those who still have some leaking after surgery often find this is less severe than it was before the operation.

However, it is not uncommon for women to need to go to the toilet more frequently and urgently after this procedure, and some find they are unable to completely empty their bladder when they go to the toilet.

In some cases, the tape can wear away or move over time and further surgery may be needed at a later stage to adjust it (for example, to make it looser) or to remove it.

Colposuspension

Colposuspension involves making an incision in your lower abdomen, lifting up the neck of your bladder, and stitching it in this lifted position. This can help prevent involuntary leaks in women with stress incontinence.

There are two types of colposuspension:

  • an open colposuspension – where surgery is carried out through a large incision
  • a laparoscopic (‘keyhole’) colposuspension – where surgery is carried out through one or more small incisions using special, small surgical instruments

Both types of colposuspension offer effective, long-term treatment for stress incontinence, although laparoscopic colposuspension needs to be carried out by an experienced laparoscopic surgeon.

Problems that can occur after colposuspension include difficulty emptying the bladder fully when going to the toilet, recurrent urinary tract infections (UTI) and discomfort during sex.

Sling procedures

Sling procedures involve making an incision in your lower abdomen and vagina so a sling can be placed around the neck of the bladder to support it and prevent accidental urine leaks. The sling can be made of:

  • a synthetic material
  • tissue taken from another part of your body (an autologous sling)
  • tissue donated from another person (an allograft sling)
  • tissue taken from an animal (a xenograft sling), such as cow or pig tissue

In many cases, an autologous sling will be used and will be made using part of the layer of tissue that covers the abdominal muscles (rectus fascia). These slings are generally preferred because more is known about their long-term safety and effectiveness.

The most commonly reported problem associated with the use of slings is difficulty emptying the bladder fully when going to the toilet. A small number of women who have the procedure also find that they develop urge incontinence afterwards.

Procedure for urge incontinence

Botulinum toxin A injections

Botox injections can help overactive bladder symptoms in women; not just for wrinkles

Botulinum toxin A, commonly known as Botox injections, best known worldwide for treating wrinkles and other cosmetic purposes. These injections are now approved for use in overactive bladder in Australia.

For these women, Botox injections to the bladder may be offered as a treatment.

What are Botox injections to the bladder?

Botox is a recently approved treatment for OAB that’s delivered via injection. It works by blocking the muscles and nerves that lead to a feeling of urgently needing to urinate. This involves passing a small telescope (cystoscope) into your bladder through your urethra (the tube that carries urine from the bladder to outside the body) and injecting between 10 and 20 injections of Botox® into your bladder wall from the inside. This helps to improve the symptoms of overactive bladder.

What are the benefits of Botox injections?

Botox is highly effective in relieving the frequency and urgency of needing to go to the toilet and reduces urinary incontinence in majority of women undergoing the injection.

For the majority of women, the beneficial effects are usually seen three to four days after the injection. The Botox injection is expected to last for six to twelve months, but this will vary for each woman.

For some women, a single treatment is all that is required: others will need repeated injections.

Any side effects?

 Sometimes urinary retention occurs (inability or difficulty to empty your bladder). In other words, the Botox injection works too well and women cannot pass urine on their own.

However, there is a small risk of you requiring to self catheterise (pass a tube/catheter in to the bladder yourself a few times a day) to empty the bladder.

Blood in your urine –This is usually minor and settles down without any treatment.

Urinary tract infection – Symptoms include increased frequency, pain or burning when passing urine and feeling unwell. This is treatable with antibiotics.

What happens after the treatment?

You can return to work the day after your Botox injection.

You will be seen in the clinic two weeks to one month after the injections.

Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG

For Treatment enquiries, please contact Dr Arun.

Contact Dr Arun
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Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding in consecutive cycles. Although heavy menstrual bleeding is a common concern among premenopausal women, it does not mean there is anything seriously wrong.

With menorrhagia, every period you have causes enough blood loss and cramping that you can’t maintain your usual activities. If you have menstrual bleeding so heavy that you dread your period, talk with your doctor. There are many effective treatments for menorrhagia.

A good indication that your blood loss is excessive is if:

  • you feel you are using an unusually high number of tampons or pads
  • you experience flooding (heavy bleeding) through to your clothes or bedding
  • you need to use tampons and towels together
  • Symptoms of anemia, such as tiredness, fatigue or shortness of breath

When to see a doctor

Seek medical help before your next scheduled exam if you experience:

  • Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than a few hours
  • Bleeding between periods or irregular vaginal bleeding
  • Any vaginal bleeding after menopause

What causes heavy periods?
In most cases, no underlying cause of heavy periods is identified.

A number of conditions may cause menorrhagia.

Common causes include:

  • cervical or endometrial polyps – non-cancerous growths in the lining of the womb or cervix (neck of the womb)
  • endometriosis– when small pieces of the womb lining are found outside the womb, such as in the fallopian tubes, ovaries, bladder or vagina (although this is more likely to cause painful periods)
  • uterine fibroids – non-cancerous growths in the womb that can cause pelvic pain
  • Non hormonal intrauterine contraceptive devices Copper T (IUCD) (also known as “the coil”) – blood loss may increase by 40-50% after an IUCD is inserted.
  • Pelvic Inflammatory Disease (PID) – an ongoing infection in the pelvis that can cause pelvic pain, fever and bleeding after sexual intercourse or between periods
  • Polycystic Ovarian Syndrome (PCOS)– women with PCOS typically have a number of cysts in their ovaries
  • blood clotting disorders such as Von Willebrand’s disease
  • adenomyosis – when glands from the lining of the uterus become embedded in the uterus muscle
  • An underactive thyroid (Hypothyroidism) – this may cause fatigue, constipation, intolerance to cold, and hair and skin changes
  • Cancer of the womb (although it is rare)

Menorrhagia is most often due to a hormone imbalance that causes menstrual cycles without ovulation. In a normal cycle, the release of an egg from the ovaries stimulates the body’s production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding.

Menstrual cycles without ovulation (anovulatory cycles) are most common among two separate age groups:

  • Adolescent girls who have recently started menstruating.Girls are especially prone to anovulatory cycles in the first year after their first menstrual period (menarche).
  • Older women approaching menopause.Women ages 40 to 50 are at increased risk of hormonal changes that lead to anovulatory cycles.

Excessive or prolonged menstrual bleeding can lead to other medical conditions, including:

  • Iron deficiency anemia.In this common type of anemia, your blood is low in hemoglobin, a substance that enables red blood cells to carry oxygen to tissues. Low hemoglobin may be the result of insufficient iron.

Menorrhagia may decrease iron levels enough to increase the risk of iron deficiency anemia. Signs and symptoms include pale skin, weakness and fatigue. Although diet plays a role in iron deficiency anemia, the problem is complicated by heavy menstrual periods.

Most cases of anemia are mild, but even mild anemia can cause weakness and fatigue. Moderate to severe anemia can also cause shortness of breath, rapid heart rate, lightheadedness and headaches.

  • Severe pain.Along with heavy menstrual bleeding, you might have painful menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require prescription medication or a surgical procedure.

If your periods are so heavy that they limit your lifestyle, make an appointment with your doctor or the specialist.

Here’s some information to help you prepare for your appointment and know what to expect from your specialist or the doctor.

What you can do

To prepare for your appointment:

  • Ask if there are any pre-appointment instructions.Your doctor may ask you to track your menstrual cycles on a calendar, noting how long they last and how heavy the bleeding is.
  • Write down any symptoms you’re experiencing,and for how long. In addition to the frequency and volume of your periods, tell your doctor about other symptoms that typically occur around the time of your period, such as breast tenderness, menstrual cramps or pelvic pain.
  • Write down key personal information,including any recent changes or stressors in your life. These factors can affect your menstrual cycle.
  • Make a list of your key medical information,including other conditions for which you’re being treated and the names of medications, vitamins or supplements you’re taking.
  • Write down questions to ask your doctor,to help make the most of your time together.

For menorrhagia, some basic questions to ask your doctor include:

  • Are my periods abnormally heavy?
  • Do I need any tests?
  • What treatment approach do you recommend?
  • Are there any side effects associated with these treatments?
  • Will any of these treatments affect my ability to become pregnant?
  • Are there any lifestyle changes I can make to help manage my symptoms?
  • Could my symptoms change over time?

Don’t hesitate to ask any other questions that occur to you during your appointment.

What you can do in the meantime

While you wait for your appointment, check with your family members to find out if any relatives have been diagnosed with bleeding disorders. In addition, start jotting down notes about how often and how much you bleed over the course of each month. To track the volume of bleeding, count how many tampons or pads you saturate during an average menstrual period.

Your doctor will most likely ask about your medical history and menstrual cycles. You may be asked to keep a diary of bleeding and nonbleeding days, including notes on how heavy your flow was and how much sanitary protection you needed to control it.

Your doctor will do a physical exam and may recommend one or more tests or procedures such as:

  • Blood tests.A sample of your blood may be evaluated for iron deficiency (anemia) and other conditions, such as thyroid disorders or blood-clotting abnormalities.
  • Pap test.In this test, cells from your cervix are collected and tested for infection, inflammation or changes that may be cancerous or may lead to cancer.
  • Endometrial biopsy (Pipelle).Your doctor may take a sample of tissue from the inside of your uterus to be examined by a pathologist.
  • Ultrasound scan.This imaging method uses sound waves to produce images of your uterus, ovaries and pelvis.

Based on the results of your initial tests, your doctor may recommend further testing, including:

  • This exam involves inserting a tiny camera through your vagina and cervix into your uterus, which allows your doctor to see the inside of your uterus.

Doctors can be certain of a diagnosis of menorrhagia only after ruling out other menstrual disorders, medical conditions or medications as possible causes or aggravations of this condition.

Specific treatment for menorrhagia is based on a number of factors, including:

  • Your overall health and medical history
  • The cause and severity of the condition
  • Your tolerance for specific medications, procedures or therapies
  • The likelihood that your periods will become less heavy soon
  • Your future childbearing plans
  • Effects of the condition on your lifestyle
  • Your opinion or personal preference

Drug therapy for menorrhagia may include:

  • Iron supplements.If you also have anemia, your doctor may recommend that you take iron supplements regularly. If your iron levels are low but you’re not yet anemic, you may be started on iron supplements rather than waiting until you become anemic.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve), help reduce menstrual blood loss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea).
  • Tranexamic acid.Tranexamic acid (Lysteda) helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding.
  • Oral contraceptives.Aside from providing birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.
  • Oral progesterone.When taken for 10 or more days of each menstrual cycle, the hormone progesterone can help correct hormone imbalance and reduce menorrhagia.
  • The hormonal IUD (Mirena).This intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping.

If you have menorrhagia from taking hormone medication, you and your doctor may be able to treat the condition by changing or stopping your medication.

You may need surgical treatment for menorrhagia if drug therapy is unsuccessful. Treatment options include:

  • Dilation and curettage (D&C).In this procedure, your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding. Although this procedure is common and often treats acute or active bleeding successfully, you may need additional D&C procedures if menorrhagia recurs.
  • Uterine artery embolization.For women whose menorrhagia is caused by fibroids, the goal of this procedure is to shrink any fibroids in the uterus by blocking the uterine arteries and cutting off their blood supply.

During uterine artery embolization, the surgeon passes a catheter through the large artery in the thigh (femoral artery) and guides it to your uterine arteries, where the blood vessel is injected with microspheres made of plastic.

  • This procedure involves surgical removal of uterine fibroids. Depending on the size, number and location of the fibroids, your surgeon may choose to perform the myomectomy using open abdominal surgery, through several small incisions (laparoscopically), or through the vagina and cervix (hysteroscopically).
  • Endometrial ablation.Using a variety of techniques, your doctor permanently destroys the lining of your uterus (endometrium) eg. Novasure. After endometrial ablation, most women have much lighter periods. Pregnancy after endometrial ablation can put your health at risk — if you have an endometrial ablation, you should use reliable or permanent contraception until menopause.
  • Hysterectomy — surgery to remove your uterus and cervix — is a permanent procedure that causes sterility and ends menstrual periods. Hysterectomy is performed under anesthesia and requires hospitalization. Additional removal of the ovaries (bilateral oophorectomy) may cause premature menopause.

Except for hysterectomy, these surgical procedures are usually done either local anaesthetic or general anaesthetic . Although you may need a general anaesthetic, it’s likely that you can go home later on the same day.

When menorrhagia is a sign of another condition, such as thyroid disease, treating that condition usually results in lighter periods.

Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG

For Treatment enquiries, please contact Dr Arun.

Contact Dr Arun
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What happens after menopause?

After menopause, a female sex hormone called oestrogen decreases. As a result, women tend to develop menopausal symptoms, commonly hot flushes, sweating, vaginal dryness and pain. The vaginal dryness also called vulvovaginal atrophy tends to result in painful sex and other symptoms like urinary incontinence. This is because vagina loses the elasticity, tends to get thinner and blood supply is reduced.

It is usually treated by oestrogen supplements and also oestrogen creams. Such patients usually fear that breast cancer may develop after oestrogen cream. Some of the patients are also cancer survivors and can’t take oestrogen to control their symptoms.

Until now, women have only a couple of choices, either put up with the painful sex or abstain from sex altogether. This can cause significant impact in intimate relationships.

Laser therapy

But this new laser treatment provides relief to the distressing symptoms and revitalize their sex lives.

After examining the woman to rule out any infections, the doctor applies numbing cream to the vaginal area. The treatment takes only 5 minutes to perform and does not need women to be put to sleep.

How it works?

Laser treatment introduces tiny holes in the vaginal lining, resulting in new blood supply to the vagina and healthy tissues.

Several studies suggest that vagina grows stronger with new blood flow and healthy vagina is formed.

Usually it is administered for a course of three cycles with 6 weeks apart but can be administered as early as 2- 4 weeks apart depending upon the severity of symptoms.

What are the benefits?

This is mainly used for the treatment of vaginal atrophy now called as GenitoUrinary Syndrome of Menopause(GSM). Various studies confirm this.

Laser treatment can also be used to treat mild stress incontinence and vaginal gaping following natural birth.

What are the side effects ?

Laser treatment is new, not covered by Medicare and costs around $1000 per treatment.

Some women experience vaginal discharge for a couple of days. It is preferable to avoid sex for 5 days after treatment to prevent infection.

It is a painless 5-minute treatment with no side effects.

Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG

For Treatment enquiries, please contact Dr Arun.

Contact Dr Arun

 

 

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