Sandra Makela, MD

There is no single answer to your question as individuals vary in response to the procedure and in the aging process.  You will need to determine your need for a maintenance procedure by the the return of clinical symptoms such as dryness and discomfort with intercourse.

It is not possible to make an accurate diagnosis of your discomfort without a complete work up which includes a history and physical examination.  Seborrheic vulvitis is rare as there are not many sebaceous glands on the vulva.  On the list of possibilities are atopic dermatitis, yeast and lichen sclerosis to name a few.  Examination of a small tissue sample may be of use and at the very least can rule out some etiologies,

The initial studies done in Italy determined that most patients attained optimal benefits with three treatments.  As clinicians have found, we individuals do not come from a cookie cutter press and there may be variation.  Patients will start with different baseline amounts of atrophy, on different medications with varying genetic factors.  I have found that 5-7 treatments are needed on the vulva if lichen sclerosis is present.  Bottom line - the physician doing the procedure needs to be proficient in evaluating the tissue and developing  a proper treatment plan for you as an individual.

The recommended follow-up interval for internal treatments is 6 weeks (40-50 days) and the interval for external treatment is 30-60 days.