Vaginal Dryness and Sexual Wellness Treatment

Resurfacing and lesion removal

Two things belong here that women almost never ask about directly.

Benign growths in intimate areas. Skin tags, moles, warts, and other benign lesions turn up here the same as anywhere else on the body, and they make women deeply self-conscious. The conventional route is surgical, which means a scalpel and stitches in an area where nobody wants either. I remove them with ablative plasma instead. No cutting, no sutures.

Labial laxity and excess tissue. Where the concern is excess labial folds, external laxity, or tissue texture, I use plasma energy to tighten and refine externally. It’s a non-surgical alternative to labiaplasty, and it’s an option for women who want the result without an operation.

Both of these involve real healing time, unlike the treatments above. Expect fourteen to twenty-one days. I call it healing time rather than downtime because your tissue is actively repairing during that window, and that repair is what produces the result. Numbing is used, and comfort during the procedure is around a four to five out of ten.

Pelvic floor, leaking, and recurrent UTIs

This has become a much bigger conversation, partly because more women are on hormone therapy and finally asking about the rest of it, and partly because referrals are genuinely hard to get.

Your pelvic floor is muscle, connective tissue, and mucosal tissue working together. Hormonal change affects all three. That’s why leaking when you laugh or lift, urgency, and recurrent urinary tract infections often arrive in the same few years as the dryness.

Where I can help: the tissue side. Vaginal estrogen improves the health of urogenital tissue, and there’s good evidence supporting it for reducing recurrent urinary tract infections in postmenopausal women. Restoring tissue quality and integrity supports the whole system, and for many women it makes a substantial difference to symptoms they’d been told to live with.

Where I’ll refer you: if muscular strength and coordination are the primary issue, pelvic floor physical therapy is the treatment with the strongest evidence behind it, and it does something my treatments don’t. I’m not a substitute for that, and I’ll say so. What I can do is address the tissue and hormonal side, which is the part most often left untreated, and work alongside a pelvic floor therapist rather than instead of one.

Between the two, most women get considerably further than they expected.

Your partner isn’t left out

Everything above has a counterpart for men, and it’s worth saying plainly, because these conversations tend to happen one person at a time when they should be happening together.

Reduced sensation, changes in erectile quality, and performance concerns respond to the same principles: blood flow, tissue quality, hormones, and the nervous system. I offer P-STIM, the plasma equivalent, and PRF-P Intimate Rejuvenation.

I also evaluate the underlying picture, because erectile changes are frequently the first visible sign of a vascular, metabolic, or hormonal issue that deserves attention on its own terms.

If intimacy has changed in your relationship, it’s rarely only one person’s biology. Both halves are treatable.

How we start

We talk, without you having to be brave about it. You will not have to work up to this in my office. I ask the questions directly so you don’t have to volunteer them, and nothing you say is going to surprise me.

We test. Systemic hormones, and whatever else your history points to. Vaginal symptoms are rarely isolated, and testing tells me whether we’re looking at a local tissue problem, a whole-body hormone problem, or both.

We start with the least invasive thing that will work. For many women that’s vaginal hormone therapy alone, and that’s enough. If it isn’t, we add from there.

We build in the right order. Tissue health first, then sensation, then the regenerative work if you want it. Skipping steps produces worse results.

And we follow up. Dosing gets adjusted, treatments get spaced correctly, and I keep checking in. This isn’t a prescription you fill once and never discuss again.

Why women in the East Bay come here

Most of the women I treat for this have already raised it somewhere and been handed a bottle of lubricant, or told it’s normal, or simply never asked in the first place.

What’s different here:

• I ask. You don’t have to find the words to bring it up, because I’ll bring it up first.

• Vaginal hormone therapy dosed for the tissue, not a systemic prescription applied in the wrong place.

• Compounded when it needs to be, for precise dosing and hypoallergenic formulation, which matters more here than almost anywhere else.

• A full non-hormonal path, for women with a breast cancer history and for anyone who’d rather avoid hormones.

• Treatments beyond hormones, including plasma energy and PRF, for sensation and tissue quality that hormones alone don’t always restore. I also prescribe vaginal testosterone where it’s clinically appropriate.

• Non-surgical options for lesions and laxity, in an area where the conventional answer is a scalpel.

• Honest boundaries. If pelvic floor physical therapy is what you need, I’ll tell you and help you get there.

• Options for your partner, so this stops being one person’s problem to solve.

• An award winning doctor with fifteen years of practice in the East Bay. I’ve been voted Best Doctor of the East Bay, and I have page after page of five star reviews that show how hard I work for my patients.

I’m in Lafayette, CA, easy to reach from Walnut Creek, Orinda, Moraga, Danville, Alamo, Pleasant Hill, and the broader East Bay.