Angela McCool-Pearson, MD

Congrats on your baby! If you aren't breast feeding, I would wait until most of your swelling goes down and then proceed. It really depends on what your goals for thermiva are. If you are breast feeding, I would use vaginal estrogen to help re estrogenize the vaginal tissue. The newer medication on the market can be prescribed in a 4 mcg dose and easily used while breast feeding. 

The average length of time between treatments for our return patients is 6-9 months. It is very patient specific and age definitely plays a role as does Hormone Replacement Therapy. Lichen Sclerosis patients seem to come on an average of every 6 mos. Younger women go 12-18 months. It would seem that friction in the vagina with intercourse would help continue the remodeling process to some degree. I tell our patients that the aging process continues and maintenance treatments will be necessary just as on any other part if the body. I am a Thermiva patient myself and a big believer in this therapy. I hope this answer helps!

In our practice, we first use a compounded topical anesthetic ointment as we were instructed by Dr. Runnels. We then perform a clitoral block with lidocaine. Lastly, we use ice to the clitoral and vaginal areas just before injecting with PRP. Using this technique, along with very small needles and not injecting too deeply allows for an almost painless procedure. I have had the procedure twice myself and experienced no pain. There is a difference in how PRP is concentrated in the centrifuge process among the various machines. We use a machine that highly concentrates PRP but still find that we can perform the O shot procedure with minimal to no discomfort. Your hysterectomy scar is not in the vicinity of the O shot injection area. The rash is likely coincidental also.