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Vaginal Rejuvenation – ThermiVa and Viveve

Renew MediSpa is the premier provider of Intimate Wellness Services in New Hampshire. Dr. Vuich is a Key Opinion Leader for Viveve, and Chief Physician Liason for Bridging Biosciences- a group which is working to develop new technologies for quality control and outcomes measurements for cell therapies such as platelet-rich plasma Dr. Vuich has participated in the design of the Transcend Customized PRP protocol- first of its kind in the nation, this protocol ensures that the dose of growth factors (platelet rich plasma) delivered meets the highest standards in the industry. She is also participating in groundbreaking clinical research in the field of sexual wellness procedures in partnership with Bridging Biosciences.

Childbirth and the natural aging process cause changes which may affect feminine wellness. A particularly strenuous vaginal childbirth, or multiple births, can cause stretching of the vagina. The effects of menopause can also cause physical and functional changes, such as excessive dryness, pain, and difficulty achieving orgasm to name a few.

Women don’t want an out-of-control feeling when it comes to their bodies, especially when it affects the most intimate part of their lives. They want to reclaim their younger or “pre-baby” bodies and both restore their sense of well being and revive their relationship.

Viveve Vaginal Rejuvenation

Renew MediSpa was the first in New Hampshire to offer Viveve (formerly Geneveve) vaginal rejuvenation. This single-session, clinically proven treatment is truly one of the most advanced treatments in vaginal rejuvenation. Viveve is a nonsurgical treatment that works at the cellular level to rebuild and restore collagen without damaging the vaginal tissues.

Vivevee utilizes cryogen-cooled monopolar radiofrequency technology to stimulate collagen production. A patented heating mechanism delivers energy deep into the tissues while a cooling mechanism protects the surface vaginal tissues. When it comes to tightening, it’s best when the treatment is able to deliver heat to the targeted deeper layers. And, Viveve’s dual system delivers heat right to these deeper layers much better than laser treatments are able to, while also making sure the delicate surrounding tissues are unharmed. The cooling system also helps keep patients comfortable and the procedure painless.

Various studies, including the VIVEVE 1 study, a large, randomized, blinded, and placebo-controlled trial have shown that not only does Viveve vaginal rejuvenation lead to no serious side effects, but that 9 out of 10 patients reported an improvement in sensation and sustained tightening that lasted for at least 12 months.

The VIVEVE 1 study also showed statistically significant improvement in arousal, lubrication, and orgasm.

Your Procedure for Viveve Vaginal Rejuvenation

Since it’s completely nonsurgical, your vaginal rejuvenation treatment can be performed in the office in under an hour. Viveve is painless, and patients will be able to go home the same day as their procedure. Viveve can be performed in a single session.

Recovery from Viveve Vaginal Rejuvenation

Because of Viveve’s dual heating and cooling mechanism, the vaginal tissues are protected from damage, so there’s no need for any downtime or a recovery period after the vaginal rejuvenation procedure. Patients are asked to refrain from sexual activity and tampon use for 48 hours.


Dr. Vuich was also one of the first physicians in New Hampshire to offer ThermiVa, a revolutionary vaginal rejuvenation treatment that can target both internal and external vaginal structures. This nonsurgical treatment uses radiofrequency technology to encourage long-term collagen production in labia and in the vaginal canal, allowing the tissues to tighten. Using a smooth, small applicator, ThermiVa applies energy to the tissues without harming them or causing discomfort. Because of its unique mechanism, ThermiVa can also help stimulate the glands in the vagina, allowing it to reverse vaginal dryness, a common side effect of aging. By allowing the patient to tighten slack or oversized labia, ThermiVa can help reduce discomfort during activities like sex, riding a bike, or even wearing snug clothing.

Your Procedure for ThermiVa

ThermiVA is performed as a series of 3 treatments over the course of 2 months. ThermiVa can be performed in the office, and it requires no anesthetic, recovery period, or downtime. It also takes less than one hour to perform. On the day of the procedure, the patient will lie on the adjustable exam table, while the small ThermiVa applicator is applied on the labia and on to the walls of the vagina. ThermiVa is painless, and many patients report only a slightly warm sensation.

Patients usually notice improvement in two weeks after their first Thermiva treatment, but the full results from their vaginal rejuvenation should be present after their series of treatments are over. THermiVa’s vaginal rejuvenation results have been shown to last for 12 months or more.

Recovery from ThermiVa

There is no downtime or recovery necessary for ThermiVa; typically, patients can engage in sexual activity the day after the treatment, but we recommend that patients make sure to check in with Dr. Vuich before doing so.

At Renew MediSpa we often combine these advanced radiofrequency treatments with platelet rich plasma- The O shot.

Thermi-O and Genny-O

What happens when you take TWO highly effective rejuvenation procedures and combine them? The result is often even more pronounced- We call this phenomenon synergy. Combining ThermiVa treatments or a Viveve treatment with The O-Shot® is a powerful tool to improve orgasms, help dyspareunia (painful sex), stop both urge & stress incontinence, relieve lichen sclerosus, increase libido, and improve sensation– for an improvement in sexual function, urinary function, and strengthening of relationships.

At the time of a consultation, we can help you to determine whether ThermiVa or Viveve/Geneveve would best suit your symptoms and goals. Both treatments utilize radiofrequency technology.

The Benefits of Vaginal Rejuvenation

Vaginal rejuvenation can address medical problems like incontinence, but by improving your quality of life, vaginal rejuvenation’s benefits are so much more meaningful. With vaginal rejuvenation, our patients can enjoy increased sensation, easier arousal, and an easier time reaching orgasm. But what’s just as important is that they can finally feel confident in their body, feel more alluring, and feel more comfortable in their skin.

Am I a Candidate for Vaginal Rejuvenation?

Patients who are pregnant, have a vaginal or bladder infection, or have current abnormal pap smears cannot have vaginal rejuvenation with either Viveve or ThermiVa.

At Renew MediSpa we feel strongly that it is time for women to “just say no” to accepting sexual dysfunction as a “necessary part of aging.” Any woman bothered by vaginal dryness, vaginal looseness, pain with intercourse, loss of libido, difficulty with orgasm or urinary leakage deserves to know that there are effective treatments available that are nonsurgical, noninvasive, with little or no downtime, that can reverse these symptoms and with maintenance can allow her to function normally during what should be the best years of her life.

Which Procedures Are Best for Me

We encourage you to contact us at Renew MediSpa for a consultation to determine which treatments or combination of treatments would best suit your needs. In addition to ThermiVa and Viveve, we offer the O Shot, the Wing Lift, and bioidentical hormone replacement with testosterone pellets (non-estrogen).

Our recommendation will be customized to your symptoms and their relative severity to ensure that you have the best experience and results during your intimate wellness journey.


Due to causes ranging from childbirth and aging to genetics, your vagina and its surrounding tissues may lose elasticity, firmness, lubrication, sensation and strength. This can lead to several issues such as urinary incontinence (leaking urine), vaginal dryness and/or painful intercourse, vaginal looseness, reduced sensation, difficulty with orgasm, and sagging/crepey skin externally.

Vaginal rejuvenation isn’t a single procedure, but rather an umbrella term that includes many different treatments. These include both surgical and non-surgical options:

Surgical Options:

  • Vaginoplasty, surgery to repair or construct a vagina
  • Labiaplasty, surgery to change the size and shape of the labia minora (“inner lips/inner labia)
  • Vulvoplasty, surgery to change the size and shape of the labia majora (outer lips/outer labia)
  • Clitoral hood reduction, surgery to reduce the amount of skin around the clitoris

Non-Surgical Options- Available at Renew MediSpa:

  • ThermiVa
  • Viveve
  • PRP Injection- the “O shot”
  • Femiwave (low intensity shockwave therapy)

Non-surgical vaginal rejuvenation can address concerns such as

  • loss of lubrication/vaginal dryness
  • reduced sensation
  • difficulty achieving orgasm
  • stress urinary incontinence
  • vaginal pain/pain with intercourse
  • lichen sclerosis

Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls and adjacent tissues which occurs most often after menopause. It is due in part to loss of estrogen effects. For many women, vaginal atrophy makes intercourse painful and may also leads to distressing urinary symptoms. Doctors use the term “genitourinary syndrome of menopause (GSM)” to describe vaginal atrophy and its accompanying symptoms.

Genitourinary syndrome of menopause (GSM) signs and symptoms may include:

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with
  • urination
  • Frequency/Urgency with urination
  • Recurrent urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

Vaginal atrophy can also occur as a result of pelvic radiation or chemotherapy effects, or as a side effect of other breast cancer hormonal treatment (such as Tamoxifen).

In most cases, unfortunately, vaginal rejuvenation is not covered by traditional insurance plans. The cost can however be covered by funds set aside in Heath Savings Accounts (HSA) or Flex Spending Accounts (FSA) which may be available through your employer.

We do not bill insurance (we are not providers with any insurance carriers) but we can usually process HSA and FSA payment cards and provide any documentation you may need to submit to support the expenditure.

We do not have “in-house financing” We recommend you visit www.advancecarecard.com We are able to process Care Credit cards for payment ONLY IF they have a major credit company logo on the card- such as Visa or Mastercard.

The procedures performed at Renew MediSpa are generally completed in under an hour.

This can be estimated during a consultation and varies by procedure. The severity and duration of your symptoms may also be a factor. We do our very best to provide a recommendation that will deliver satisfactory results!

Yes, all of our equipment has been cleared for use by the FDA.

Vaginal rejuvenation procedures at Renew MediSpa are primarily performed by our trained female RNs, but may also be performed by Dr. Vuich. The Femiwave procedure can be performed by MD, RN or medical assistant. We have been performing these procedures successfully since 2016.

The only vaginal rejuvenation procedure at Renew MediSpa which requires numbing cream is the platelet rich plasma injection (PRP injection/”O-Shot”). We are able to perform this and all other procedures with minimal to no discomfort.

A consultation is recommended in order for us to make the best recommendation regarding your treatment plan. We will base our recommendation on the type of symptom(s) you are experiencing and the severity of the symptom(s), and your history of past treatments/interventions. In some cases you will have more than one treatment option available to you, or a combination of procedures may be recommended. The Sexual Wellness consultation can be booked with an RN or medical assistant. If you live over an hour from our location, we may be able to accommodate phone consultations as well.

Primary contraindications include:
Active malignancy or receiving chemotherapy
Active infection in the treatment zone
Active MESH complication
Pacemaker or Implanted Defibrillator is a contraindication for radiofrequency-based procedures such as ThermiVa or Viveve Uterine prolapse- (will not improve with treatment)

Noticeable improvement can begin as early as 2 weeks after a regenerative procedure, and continue to improve for up to 3 months.

It is very important in this instance that you have been evaluated by a gynecologic specialist if you have significant vaginal/pelvic pain. Not all causes of pelvic pain are treatable with vaginal rejuvenation. If the cause of the pain is vulvovaginal atrophy (most commonly due to postmenopausal changes) then these treatments are excellent! What we cannot say is exactly how many sessions will be required in order for you to be feeling “back to normal” or better. In our experience, treatment failures are rare.

This will vary of course, but in general vaginal rejuvenation procedures are recommended to be performed every 1 to 2 years. Maintenance procedures help to retain the tissue health and prevent symptom recurrence. Many of our women’s wellness clients schedule their maintenance procedure the way you would schedule a yearly physical exam. Others prefer to “wait until symptoms begin to return” before booking a booster procedure.

In our opinion, it is best to treat symptoms earlier rather than later. Also remember that results/improvement will be gradual rather than instantaneous, and that maintenance treatments every 1 to 2 years are recommended.

Most of the women we see for these procedures have already tried oral and/or topical hormone replacement therapy and failed to sufficiently improve their symptoms. If you are on hormone replacement you can continue it – it will not interfere with your results. Always discuss any plans to change prescription medication with your health care providers. In our experience, women using topical hormones in the vaginal canal usually come off of those medications once they have a vaginal rejuvenation procedure performed.

This is a complex question with no easy answer, but we hear it all the time. Primary care providers are certainly usually managing a very high caseload these days, so time may be a factor. They also may not have read the studies backing these specific types of procedures, and thus do not have the information they need to have the discussion. In some instances we feel they may not be comfortable recommending something that is “not covered by insurance”.