RESTORING INTIMATE COMFORT

Dr Ioannis Liakas highlights the use of a non-hormonal treatment for vulvo-vaginal atrophy

Vulvo-vaginal atrophy (VVA) is a common yet often underdiagnosed condition affecting many women, particularly during and after menopause. It occurs due to a decline in oestrogen levels, leading to thinning, drying and inflammation of the vaginal walls. Symptoms can include vaginal dryness, irritation, itching and painful intercourse, all of which can significantly impact quality of life and intimate relationships. VVA is especially prevalent in women who are unable to take hormone replacement therapy (HRT), such as those with a history of hormone-sensitive cancers. As awareness grows, there is increasing demand for safe, effective, non-hormonal treatments that can restore comfort and function without the use of systemic hormones.

PATIENT BACKGROUND

Sarah, a 52-year-old breast cancer survivor, presented to the clinic with severe symptoms of VVA, including persistent vaginal dryness, painful intercourse and general genital discomfort. These symptoms developed following chemotherapy and the discontinuation of hormone replacement therapy (HRT), which was contraindicated due to the hormone-sensitive nature of her cancer.

Having been post-menopausal for several years, Sarah’s VVA symptoms were further compounded by the abrupt cessation of HRT. She had previously trialled over-the-counter vaginal moisturisers and lubricants, which provided only temporary and superficial relief. The lack of long-term improvement and the physical pain caused by vulvar vestibulitis had led Sarah to withdraw from sexual activity entirely.

TREATMENT RATIONALE

Given Sarah’s medical history and inability to use hormonal or invasive therapies, the Caress Flow protocol was selected. This treatment combines high-concentration oxygen therapy with low molecular weight hyaluronic acid to hydrate tissues, improve elasticity and stimulate collagen production – all without hormones or invasive procedures.

The gentle design of the device and its minimal risk profile made it an ideal choice for Sarah, particularly as she was not a suitable candidate for vaginal laser or radiofrequency treatments due to pain sensitivity.

TREATMENT PROTOCOL

Sarah underwent six weekly sessions of Caress Flow in line with the manufacturer’s recommendations. The standard protocol was followed closely, although the oxygen delivery was adjusted to suit Sarah’s comfort levels and ensure a pain-free experience. No additional in-clinic therapies were used during this period, but she was advised to continue with high-quality moisturisers and lubricants between sessions to support hydration.

MECHANISM OF ACTION

Caress Flow works by delivering high-concentration oxygen to improve microcirculation and cellular metabolism, while the low molecular weight hyaluronic acid enhances hydration and elasticity. The combination encourages fibroblast activity and collagen synthesis, contributing to stronger, more resilient vaginal tissue.

PATIENT EXPERIENCE AND TOLERANCE

Sarah described the sessions as completely comfortable and free from pain, likening the experience to a “spa for the vagina”. She reported sensations of warmth and relaxation during treatment and observed immediate post-session benefits. No side effects or adverse reactions were reported throughout the course.

RESULTS AND CLINICAL OUTCOMES

By the third session, Sarah began to report noticeable improvements. By the end of the treatment series, she described herself as “almost completely pain-free” and significantly more comfortable during intimate activity.

Clinical assessments showed visible improvement in mucosal hydration, elasticity, and tissue resilience. Patient-reported outcome measures documented these improvements, confirming the efficacy of the treatment.

COMPARATIVE OUTCOMES

In the clinic’s broader experience, Caress Flow has produced results that are at least on par with, and often superior to, other modalities such as Desirial injections, radiofrequency or hormonal therapies– particularly in terms of patient comfort and satisfaction. The non-invasive, hormone-free nature of Caress Flow has consistently led to quicker symptom relief and higher overall patient acceptance.

LONG-TERM IMPACT AND FOLLOW-UP

Several months post-treatment, Sarah continues to experience lasting relief from her symptoms. While no maintenance sessions have yet been necessary, her condition will be reassessed periodically to determine future needs.

In clinical experience, repeated courses of Caress Flow may provide cumulative benefits, supporting long-term vaginal tissue health and sustained improvement in quality of life.

CLINICAL REFLECTIONS

This case underscores the value of Caress Flow as a reliable, well-tolerated and effective solution for managing VVA in patients who are unable to undergo hormone-based treatments. While the treatment is generally safe, it should be avoided or adapted in cases of active vaginal infection or recent pelvic surgery.

Emerging research supports the integration of oxygen and hyaluronic acid therapy in vaginal rejuvenation, affirming Caress Flow’s role as a valuable addition to the clinician’s toolkit.

DR IOANNIS LIAKAS

Dr Ioannis Liakas is the medical director and lead medical practitioner at Vie Aesthetics, which has locations in London, Essex and Germany. Dr Liakas has decades of experience as an NHS Consultant of Internal Medicine and Gerontologist, and he has been an experienced practitioner in aesthetic medicine for more than 14 years. Dr Liakas is a Fellow of the Royal College of Physicians (FRCP), Honorary Senior Lecturer at Queen Mary Medical School, and a Member of the British College of Aesthetic Medicine.