Medically reviewed by Mark Strehlow, MD, Medical Director — September 2026
“Vaginal rejuvenation” isn’t a diagnosis. It’s a broad label for treatments marketed for dryness, pain during sex, a feeling of looseness, leaking, or changes in sensation, usually after childbirth or menopause. Those concerns are common and worth taking seriously. We offer ThermiVa, a radiofrequency treatment. This page explains what it is, what the FDA has and hasn’t cleared it for, its risks and price, and the better-studied options we usually start with. Treatment is done by Hannah Osborn, APRN, or Angela Barnett, MD. Consultations are private and free.
At a glance
- What it is
- A radiofrequency treatment: a slim wand warms the tissue of the vulva and vagina. No surgery or needles.
- How it starts
- A free, private consultation about your symptoms and history, with a short questionnaire.
- Each treatment
- About 25 minutes; numbing usually isn’t needed, and most women go straight back to normal activities.
- Series and price
- 3 treatments about a month apart for $2,400; optional maintenance is $500 a treatment.
- Who you’ll see
- Hannah Osborn, APRN, or Angela Barnett, MD.
Start with the cause
Each of these concerns has its own common causes, and its own best-studied first steps.
| What you notice | Common causes | Where we usually start |
|---|---|---|
| Dryness, burning or pain during sex | Lower estrogen around menopause, after childbirth or while breastfeeding; some medications | Lubricants and vaginal moisturizers; prescription vaginal estrogen if it suits you |
| Leaking when you cough, laugh or exercise | Weak or strained pelvic-floor muscles, often after childbirth | Pelvic-floor (Kegel) exercises, ideally taught by a pelvic-floor physical therapist |
| A feeling of looseness after childbirth | Changes in the pelvic floor and the vaginal opening | An exam, then pelvic-floor physical therapy or a referral to an OB/GYN |
| Lower desire, arousal or sensation | Hormones, medications (including many antidepressants), pain, stress or relationship strain | An evaluation, with labs where they help; counseling or sex therapy when that’s the better fit |
Low-dose vaginal estrogen is the best-studied treatment for dryness and painful sex after menopause, and we prescribe it when it suits you. When a pelvic-floor physical therapist or an OB/GYN is the better fit, we’ll refer you.
What ThermiVa is
ThermiVa is a radiofrequency device. Your provider moves a slim wand over the vulva and inside the vagina to warm the tissue, keeping it within a set temperature range. It isn’t surgery, and it doesn’t use needles. Devices like it are often marketed as “vaginal tightening” or “non-surgical vaginal rejuvenation.”
What the FDA has and hasn’t cleared
- In the United States, ThermiVa’s FDA clearance is “for use in dermatological and general surgical procedures for electrocoagulation and hemostasis,” meaning using heat to control bleeding during surgery. It isn’t cleared for any vaginal, sexual or bladder symptom, so using it for those is off-label.
- In 2018 the FDA warned that energy-based devices used for vaginal “rejuvenation,” or for symptoms related to menopause, urinary incontinence or sexual function, can cause serious harm, including vaginal burns, scarring, pain during sex and recurring or chronic pain. It said it had not cleared or approved any device for those uses, and that it had not been established whether the devices work for them or how much harm they can do.
- The FDA contacted the makers of these devices, including the maker of ThermiVa, about how they were marketed. By November 2018 it reported that they had responded with adequate corrections.
What the research shows
Studies of radiofrequency treatment for these concerns are mostly small and short, and many have no comparison group. The American Urogynecologic Society’s expert panel found no evidence that radiofrequency helps stress incontinence. It could not agree that radiofrequency shows promise for vaginal looseness, and it found no objective data on how these devices affect the appearance of the vulva or vagina. That’s why we won’t promise you a result. Individual results vary.
Is ThermiVa an option for you?
We offer ThermiVa only after an evaluation, and usually after you’ve tried or ruled out the options above. Before treatment you need a pelvic exam from within the past year, to rule out other problems. We can do it here, or your gynecologist can.
ThermiVa isn’t for you if you: – are pregnant – have a fever, or an infection in or around the area – have cancer in the pelvic area, or have had pelvic surgery recently – have an abnormal area on the vulva, vagina or cervix that hasn’t been checked
Tell us if you have a pacemaker or another implanted electronic device, vaginal mesh or a sling, or if you’ve had pelvic radiation, so your provider can decide whether ThermiVa is appropriate.
What happens with ThermiVa
- Free consultation. We talk through your symptoms and review your history and medications. You fill in a short questionnaire about sexual function (the FSFI), which helps us understand where you’re starting from and track how things change. We also arrange your pelvic exam if you haven’t had one in the past year. You’ll get the price in writing.
- Treatment. You lie on an exam table, as for a pelvic exam. Your provider moves the wand over the vulva and inside the vagina, checking the temperature and your comfort throughout. A session typically takes about 25 minutes, and numbing usually isn’t needed.
- Afterward. Most women go straight back to their normal activities.
- The series. A standard ThermiVa series is three treatments about a month apart.
- Maintenance. Some women choose a single maintenance treatment later, typically about once a year. There’s little published research on maintenance, so we’ll decide it with you.
Risks
You’ll feel warmth during treatment. Afterward, temporary discomfort, redness or swelling can occur. Studies of vaginal energy-based devices also report more discharge, spotting, bacterial vaginosis and urinary tract infections. Burns and scarring are rare but have been reported, and the FDA has received reports of pain during sex and long-lasting pain. Long-term effects aren’t known.
What ThermiVa costs
| Price | |
|---|---|
| Consultation, including the FSFI questionnaire | Free |
| ThermiVa series: 3 treatments, about a month apart | $2,400 |
| Maintenance treatment (optional, after a series) | $500 per treatment |
ThermiVa is cash-pay and isn’t covered by insurance. You’ll get your total in writing at the consultation, before anything is done.
Other options we offer
- Vaginal estrogen, which we prescribe when lower estrogen is part of the picture.
- Hormone care for women, when broader menopause symptoms are part of it.
- Referrals to pelvic-floor physical therapists and OB/GYNs.
- Looking for the O-Shot? We no longer use PRP. Our women’s sexual wellness injection page explains what we offer instead. It uses umbilical cord–derived tissue matrix products from an FDA-registered tissue bank. Registration is not approval, and no product of this kind is FDA approved.
- Reading: what the research says about sex and women’s health
Common questions
Does ThermiVa work?
The research is limited. Studies are small and short, and the FDA hasn’t cleared ThermiVa or any similar device for vaginal, sexual or bladder symptoms. We can’t promise a result, and individual results vary.
Does it hurt?
You’ll feel warmth. Tell your provider if it becomes uncomfortable, and they’ll adjust.
How many treatments will I need?
A standard series is three, about a month apart. Some women add a maintenance treatment about once a year.
Can ThermiVa help with bladder leaks?
It isn’t cleared for that, and the expert panel above found no evidence that radiofrequency helps stress incontinence. Pelvic-floor physical therapy is the usual first step, and we’ll refer you to a specialist to discuss other treatments.
Is ThermiVa the same as laser vaginal rejuvenation?
No. ThermiVa uses radiofrequency energy, and vaginal lasers use light. The FDA’s 2018 warning covered both kinds of device. We don’t offer laser treatments.
Is it the same as the O-Shot?
No. The O-Shot is an injection of platelet-rich plasma, which we no longer use. See our women’s sexual wellness injection.
Book a free consultation
Book a free consultation, or call (913) 727-7700. See all of our sexual wellness care.
Sources (9)
- U.S. Food and Drug Administration. FDA Warns Against Use of Energy-Based Devices to Perform Vaginal “Rejuvenation” or Vaginal Cosmetic Procedures: FDA Safety Communication. July 30, 2018 (content current as of November 16, 2018). Archived copy: https://web.archive.org/web/2019/https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm615013.htm
- ThermiGen, LLC. ThermiVa Indication & Safety Information. https://thermiva.com/indication-safety-information/
- U.S. Food and Drug Administration. 510(k) K130689, Symphony RF Generator (Thermigen, Inc.), cleared November 15, 2013. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K130689
- Thermi. Thermi Receives Notice of Complete and Satisfactory Closure of FDA’s “Vaginal Rejuvenation” Inquiry. PR Newswire, November 15, 2018.
- Alshiek J, et al. Vaginal Energy-Based Devices: AUGS Clinical Consensus Statement. Female Pelvic Medicine & Reconstructive Surgery. 2020;26(5):287–298; updated in Urogynecology. 2022;28(10):633–648.
- Alinsod RM. Transcutaneous temperature controlled radiofrequency for orgasmic dysfunction. Lasers in Surgery and Medicine. 2016;48(7):641–645.
- Vanaman Wilson MJ, et al. Histologic and Clinical Changes in Vulvovaginal Tissue After Treatment With a Transcutaneous Temperature-Controlled Radiofrequency Device. Dermatologic Surgery. 2018;44(5):705–713.
- MedlinePlus. Vaginal dryness (atrophic vaginitis). https://medlineplus.gov/ency/article/000892.htm
- MedlinePlus. Kegel exercises – self-care. https://medlineplus.gov/ency/patientinstructions/000141.htm
ThermiVa® is a registered trademark of its owner. O-Shot® is a registered trademark of its owner; Rock Creek Wellness is not affiliated with it and does not perform that procedure. This page is educational and is not medical advice. Individual results vary.