Dr. Herzog, who has offices in Staten Island and Brooklyn, believes his procedure can potentially help millions of women. But, he cautions, that’s still only a small percentage of all women who have pain during sex for various reasons. “For every 10 patients who present to me with this problem, only two are actual candidates for my procedure,” he says. “Surgery is always a last resort. I work extremely hard with the patients to get them to a point where their vaginas are able to receive painless penetration, utilizing every non-surgical option available.”
Topical estrogen is the gold standard for elasticity issues, he adds, and will work in the majority of women who use it properly. But for those who cannot or will not use it, the LAVA procedure is another solution.
If this sounds too good to be true, there may be a catch: The $5,000 procedure is not covered by insurance, and not everyone in the medical community is on board with the idea. Mary Jane Minkin, MD, professor of gynecology at Yale University and co-author of The Woman’s Guide to Menopause and Perimenopause, cautions strongly against any type of vaginal surgery.
“A dry atrophic vagina does not need surgery; it needs lots of estrogen, delivered to the vagina, and occasionally systematically,” she says. Dr. Minkin sometimes recommends dilators (like those found at vaginismus.com) in conjunction with vaginal estrogen cream to open up a too-tight vagina, and on rare occasions she might suggest surgical intervention to a woman who’d had previous surgery and been “closed up too tightly,” she adds. “But for your average post-menopausal woman who has a dry vagina, surgery is the last thing she needs to open her up.”
Yet Dr. Herzog says the procedure has been a complete success for more than 80 patients, including Bianchini, whose in-office procedure took only about two hours. She was back to work by the third day. “The total recovery time was maybe a few weeks, but only a few days of being sore,” she says, “I had no complications at all, and now sex is so much better. We can be spontaneous, and I don’t have to think of whether it will be uncomfortable, because it isn’t.”
