The Pajama Problem
The funny thing about women is that most of them find within themselves continual room for personal improvement. Age management has melted wrinkles; tummy tucks have vanished signs of childbearing; breast augmentation has reversed the effects of gravity and time. The 21st century has made it possible for today’s woman, regardless of age, to regain her glory days through increased skin elasticity and decreased occurrence of blemishes from head to toe. Advances in science have made rejuvenation of any body part possible, making true the statement “Where there’s a will, there’s a way.”
Sexual well-being is just one more area in which doctors are striving to improve the quality of life for both men and women today. Men can overcome problems such as erectile dysfunction through prescriptions drugs like Viagra and Cialis. While there are no pills available to women, there are procedures to enhance their sexual experiences and return the condition of their vaginas and other related areas to a state more similar to that of former days.
Bringing Rejuvenation to Charleston
As the founder of the Cunningham Laser Vaginal Rejuvenation Institute, Dr. Jan Cunningham is the only doctor in the region that specializes in Laser Vaginal Rejuvenation®. A medical school graduate from West Virginia University, he enjoyed obstetrics and surgery from the beginning. He decided to move away from obstetrics after more than 4,500 patient deliveries, however, and focus his attention on gynecology and gynecologic surgery.
His appreciation for gynecologic surgery and laser work (endoscopies and laparoscopies) was a long-time interest. When he ran across an article concerning Laser Vaginal Rejuvenation®, he was intrigued by the prospect of using a laser to rejuvenate the vaginal structure as certain types of laser energy could provide an almost bloodless surgical field. He researched the topic for a year and a half before contacting the Laser Vaginal Rejuvenation Institute of Los Angeles and speaking with Dr. David Matlock, the developer of the procedure. “I do a lot of surgery and it was just kind of a natural fit with the laser work I had done in the past,” he says of the opportunity the institute offered him.
Cunningham says that one of the things the institute looks at in applicants is the student’s basic attitude toward women’s health care, as well as experience, both laser and surgical. “I think I have an attitude towards women’s health care that is very proactive and pro-woman. Number one, I believe in listening to women. Number two, I’ve always felt women, as well as the physicians who take care of women, have been discriminated against in general in regard to availability of options. Men are able to have their Viagra, their Cialis, their penile implants. They’re able to have procedures done on a weekly basis, but nothing’s been offered with regard to the female. Now I can offer that.”
The Pajama Problem
Cunningham’s wife, Lynn, who manages the medical office, points out that in the past when women expressed their concerns, saying “Things just aren’t the way they used to be” or “It doesn’t feel like it used to feel,” these statements were usually dismissed as being a normal part of maturity. “If there were no defects that indicated a need for surgery,” she explains, “then there really wasn’t anything to offer. Now a woman can choose a surgical alternative if she wants. She has a choice now.”
There are many situations like this that might constitute the consideration of Laser Vaginal Rejuvenation®. Throughout life, both in women who have had children and women who have not, the vaginal tissues are stretched. In the past, patients who underwent vaginal surgeries did so to correct anatomic defects and were generally in their late 40s, 50s and early 60s. That is not the case today. Patients seeking out Laser Vaginal Rejuvenation® are not trying to fix anatomic defects; they have sensation problems and/or loose intercourse—sex just doesn’t feel the same to them anymore.
In addition to the rejuvenation of the vaginal walls, other problems associated with childbirth can be fixed. Women who experience a dropped bladder, for instance, can be provided with a new support for the bladder wall during the procedure. “When you bring those tissues back together that have been separated by a baby coming through,” Cunningham says, “they’re brought back together by the tissues and the bladder itself is actually resupported.” He also explains that having this procedure at an early age can prevent the anatomic defects that come later in life from taking place, calling it a “quality of life” decision.
Cunningham became known as the “pajama doctor” after one of his patients referred to her sexual concern as “the problem in (her) pajamas.” His typical patient is any woman who is not happy with what’s going on in her sex life, with what she perceives to be her appearance or her sexual function or what she perceives to be a problem with how her husband reacts to her. “I’ve seen some young patients that want vulvar work done because they have one labia a lot longer than the other and it doesn’t look symmetrical,” Cunningham explains. “We’ve always been taught that symmetry is good, similar to the girl who has one breast markedly larger than the other. With school-age girls, if it becomes noticeable in the gym or in the showers, it can be a very stressful situation. A vulvar dissymmetry can also be uncomfortable and can contribute to painful intercourse, and now that can be corrected. I’ve also seen the woman that has had two or three children and now has a gaping introitus (opening of the vagina) where the Normal slit used to be. You truly become ‘resculpted’ with Designer Laser Vaginoplasty®.”
Knowledge is Power
Cunningham is a firm believer that women need to possess the knowledge to be able to make decisions in regard to their health care. “This is all about the patient and what the patient wants,” he explains. While Matlock’s patients in California are more familiar with the wider range of available procedures, Cunningham mostly performs Laser Vaginal Rejuvenation® (strengthening the inner walls) and Designer Laser Vaginoplasty® (resculpting the outer genitalia).
Vaginal rejuvenation includes resculpting and reforming the front vaginal wall underneath the bladder and the back vaginal wall of the rectal area and bringing those together with supportive tissues so the effective diameter of the vaginal walls is diminished. It also involves reapproximating the tissues of the perineum—the area between the vaginal opening and the rectum that provides the shelf for the introitus—to resupport all those structures.
Generally these procedures, which are considered cosmetic and not covered by insurance unless an anatomic defect is involved, are outpatient with the patient going home the same evening. Down time includes taking it easy for a week and no sexual activity for a month. Follow-up appointments are scheduled every two weeks for six to eight weeks. The necessity of touch-ups is always possible, particularly on vulvar procedures.
Cunningham’s patients are not all West Virginia citizens. As the only doctor in the region to perform these types of procedures, he has treated women from surrounding states who have had concerns about their sexual well being and continues to welcome them. Beginning in the spring of 2008, the Cunningham Laser Vaginal Rejuvenation Institute will be offering a special package for the out-of-town patients that will make the procedures easier to plan for. “The package will include a hotel stay, as well as the costs for the hospital, anesthesia and the doctor,” Lynn explains. “The price will be all-inclusive for our out-of-town patients and everything will be handled very discreetly.”
Something to Talk About
“Vaginal rejuvenation is a matter of what the woman wants,” Cunningham says. “If she thinks she has a problem, we should discuss the issue and the alternatives. If she doesn’t think she has a problem, then there’s no real reason for me to believe that she has a problem. It’s not about me. It’s about her. I think a lot of women are just as concerned about the perception of their husbands and what they think about them as their own perception of themselves. I don’t think it’s discussed, but they always think, ‘I wonder if he thinks I’m beautiful down there.’”
Women are more open to discussing sexual issues today. Cunningham is striving to inform the women in the Capitol City’s surrounding area that they don’t have to discount their own concerns any longer—that the problems that have always been deemed “a normal part of aging” don’t have to hinder their happiness or sexual well-being. “Many clinicians are fairly uncomfortable in discussing this issue with regards to sexual response and orgasm,” Cunningham says. “We hope that through our work this topic will become a much more readily talked about subject.”
