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C02RE Intima, Treatment for women’s vaginal health- Michele Westendorf, NP-C


One of newest and most exciting additions to NBDPS is the CO2RE Intima — a much needed and much welcome addition to women’s health. The benefit of fractional CO2 for resurfacing and wrinkle improvement for the face has been well established. Recently, that technology has been adapted to address the needs of of the feminine area. The Intima is designed to treat the vagina, vulva, and introitus.

As women age, estrogen levels decline. The resulting vaginal atrophy causes vaginal dryness and alterations in vaginal mucosa. Increased vaginal pH levels, increased yeast infections, and decreased collagen of the connective tissue in the vagina leads to laxity. Vaginal atrophy can lead to dryness, itching, burning and painful sex. After childbirth many women experience a stretching of vulvar tissue and urinary incontinence.
Up until now, this has been an important area of women’s health with few interventions. Topical estrogen creams can help maintain normal vaginal pH and decrease dryness but are unable to address tissue laxity. Hormone replacement therapy can increase the risk of breast cancer and heart attacks, and are also unable to address urinary incontinence and tissue laxity. Breast cancer survivors often experience vaginal dryness and are not candidates for hormone replacement therapy.

Intima is a new laser treatment with no pharmaceuticals necessary, and no effect on hormone levels. Intima is for: women who have experienced loss of flexibility and shape of the vaginal canal after childbirth, women who experience painful intercourse, dryness, itching and burning of the vagina, and women who are interested in modifying the appearance of the vulva- including pigmentation. Intima treatments help women decrease vaginal atrophy by stimulating the collagen in the vaginal mucosa and can improve appearance of the vulvar area and comfort during sex.

Treatment at NBDPS is divided into 3 easy procedures, 4 weeks apart. Plan to be in the office for about 60 minutes. Local numbing cream is applied 30 minutes before the procedure starts. Most women report little discomfort during the procedure due to the use of topical numbing cream and Tylenol/ ibuprofen. If you prefer and you have a driver, stronger pain relief can also be given in the office (but most do not find this necessary). Women with an IUD are still candidates and any piercings should be removed prior to treatment. Women should plan to abstain from sexual activity for 1 week after, and the procedure should not be performed during the menstrual period. The vulvar area to be treated should be completely shaved the night prior to treatment. Most patient feel and see improvement even after the first treatment. There are two separate sterile single use handpieces.

The External Hand Piece:

The Internal Handpiece is a small tube that is attached to an articulating arm with 360 degrees of rotation. The energy stimulates a healing response that increase moisture levels in the vaginal canal and remodels the vaginal tissue fibers which helps restores the flexibility and shape. A specialized treatment protocol is utilized for women who struggle with mild urinary incontinence. The External Handpiece is used on the vaginal opening and the labia. Using well established fractional CO2 technology energy is delivered to the tissue stimulating remodeling of the labial and vulvar tissue fibers, restoring flexibility and shape. This can also help with with pigmentation.

In one study, 100% of patients reported satisfaction with the treatment and 94% of women said they would recommend it. We are finding that patients are extremely happy with the procedures in terms of the results that they get, and also the comfort, simplicity, and safety of the procedure itself. It’s exciting for us that our years of experience in vulvar dermatology and laser therapies have finally come together!