Vaginal Rejuvenation


Vaginal Rejuvunation

by Jeff Morris

Dr. Anna Cabeca knows that vaginal health is extremely important in women’s lives, and not only in their reproductive years. “We need to maintain vaginal health all our lives,” she says. “Vaginal health is a significant indication of internal health. And sex continues throughout our lifetimes. We want our health and function to be as optimal and vital as possible.”

Dr. Cabeca is is board certified in gynecology & obstetrics, as well as anti-aging and age management medicine. She is Chief Medical Officer of Cabeca Health, an integrative medicine practice in Brunswick, Georgia, the area where she has been practicing since 1999. Vaginal health is one of her primary concerns. “I take the vagina seriously because I’m a gynecologist, but also because when I started practicing in rural Georgia, three of my patients in the first six months had serious vaginal disease. I’ve had patients tell me they were told that they never need to have another pap smear after a hysterectomy or after menopause because they would never have any other issues. This is a very grave misconception and misinterpretation. The pap smear is not only a cancer test for the cervix, but also assesses vaginal cancers. The vagina still needs to be examined.”

The importance of the vagina, she notes, is illustrated by the fact that “all life has begun at some point or another through or within” it.  “We continue,” she says, “despite being past the reproductive years, to consider the vagina very important for overall health: vaginal dryness, vaginal pain, atrophy, prolapse, loss of pelvic support, vaginal support allowing the bladder to sink, the rectum to prolapse into the vagina… these are all issues of poor vaginal health and poor muscle strength in the vagina, and can be associated with fascial breaks along the vagina as well.”

Dr. Cabeca emphasizes that vaginal health is a significant indication of internal health. “The vagina is a representation of our internal health,” she says, “and sex continues throughout our lifetimes as well. So it’s important to maintain vaginal health all our lives. We want our health and function to be as optimal and vital as possible.”

Several factors can make a difference in vaginal health, she says, addressing specifically the lining of the vagina, the mucosal layer, the muscular layer, and the intimal layer—the layer in between. “The health of this tissue can be affected by our intestinal health,” notes Dr. Cabeca. “We need to make sure we have enough good bacteria within our body, and keep the acid/pH balance stable. The vagina should be acidic, and that will keep bacteria and infections reduced.”

The main complaints women have that need to be addressed, says Dr. Cabeca, are vaginal dryness, pain during intercourse, and recurrent vaginal discharges. She outlines three key things women can do today for vaginal health:

1. Healthy vaginal probiotics or internal probiotics in a healthy digestive system: lactobacillus and bifidobacterium are the ones most commonly used for the vagina. “They can be taken orally, preferably on an empty stomach, or by making a vaginal douche with a suppository using a little bit of filtered water,” explains Dr. Cabeca. “This can be inserted, or they can dissolve a probiotic capsule that has at least 50 billion multistrains of good bacteria, mixing it with a little bit of water, and douche with it.” Alternately, it can be mixed with a little bit of yogurt (if there isn’t a dairy intolerance) and inserted into the vagina. “This is the only time I’ll recommend douching,” adds Dr. Cabeca, “normally I’m against douching because it does disturb the vaginal pH. You can get the probiotics at a health food store; high quality strains make a difference.”

2. Vaginal moisture during intercourse: dryness can be very uncomfortable. Coconut oil is the best remedy, says Dr. Cabeca. “Extra virgin organic coconut oil is my favorite oil,” she notes. “A little bit goes a long way. It is very good for soothing skin, especially in the tender vaginal area; it will not irritate or burn.”

3. Vaginal DHEA: An article in Menopause: The Journal of the North American Menopause Society[Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women. 2009: Vol. 16, No. 5, pp. 923/931] addressed the effects of vaginal DHEA on libido/sexual function in postmenopausal women, and showed 10 mg of vaginal DHEA over a period of 12 weeks resulted in a 23% improvement of desire, a 75% improvement of arousal and lubrication, and 57% improvement in dryness during intercourse, all vs. a placebo. Results were universally significant and improved.

Another study looked at effects of vaginal dryness and DHEA use at different 2.5 mg, 5 mg and 10 mg dosages, and the 5 and 10 mg dosages were shown to have made significant improvements in vaginal dryness and atrophy and all three layers of the vaginal tissue including the musculature, without any systemic or increase in blood levels of estrogen. “And that is key, as estrogen works only on the lining, the mucosal layer, but DHEA goes deeper. My patients are finding this to be so amazing.”

“I worked with a pharmacy to create vaginal DHEA tablets because where my practice is located, with all the heat and humidity, suppositories will melt. My patients use these 10 mg vaginal tablets. It can be inserted with an applicator just like a tampon, will stay and not create any kind of messy discharge as many suppositories do. I typically will start them on once a day every day for 2-4 weeks, then many women can go down to 3-5 times a week, some less; some need to continue daily until they get good restoration in their vaginal tract. One of my patients was so excited, she said, ‘Dr. Cabeca, my vagina is 20 again!’ “

Those are just three of the key things that can be done relatively easily to achieve vaginal rejuvenation. Dr. Cabeca will discuss this topic in more detail at the upcoming Age Management Medicine Conference in Las Vegas.

More information is also available at

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13 thoughts on “Vaginal Rejuvenation

  1. Question: on this site you say that you treated patients with combination of DHEA and testosterone. Now however your new product, Julva, has DHEA but not testosterone. Can both be used?
    And if use DHEA internally, can you use Julva externally also or just one or the other?

    1. Hi Georgia, good question… note that:
      – testosterone is by prescription only…
      – If you have been prescribed vaginal DHEA it is a good idea to check your levels. You may want to alternate the use of both, i.e. use your vaginal rx one day and Julva the next and so forth. This way you aren’t getting doubly dosed, considering that I don’t know your DHEA levels or dosages of your rx. Talk with your doctor about what is the best medical approach for you…your doc will know your levels (or can test for them)…

    1. This is a great question and the research is ongoing but appears favorable and it is best to discuss this with your oncologist. Julva topical feminine cream should be used with your oncologists clearance and I do not recommend it when on Tamoxifen currently.

      There is a blog with some other info relating to breast cancer at:

      Again, discuss this with your oncologist, only he/she knows your health history, etc.

  2. Hello, Dr. Cabeca!

    I have some live probiotics that I would like to use to do the vaginal douche. Do I need a specific tool to do the douche or what can I use to do it internally? What do you recommend? I never douched, therefore I am a bit clueless about how to go about it. Thanks!

  3. Ive mixed coconut oil with the contents of a probiotic capsule and then frozen the mixture to create a vaginal suppository. It melts quickly, so I insert prior to bed. This seems to work well for any discomfort such as dryness, discharge or odor.

  4. Hello Dr. Cabeca,
    Unfortunately, I don’t live in USA and very hard to get your DHEA vaginal tablets. Would be the same if I use the oral DHEA supplement of 5-10mg and insert it vaginally instead? Please advise

    1. Hi Jenny, I do not recommend inserting an oral tablet vaginally without your physicians approval. Your physician can prescribe Intrarosa.
      And my Julva topical anti-aging cream is a 2 month supply so it is very affordable with so many good client reports.

  5. Hi I’m currently undergoing IVF with many cancelled cycles because my lining does not reach over 6mm I get to 5.8 then it flat lines. I am on estrace to help with the lining wondering of your DHEA supposity could help. If it works at a deeper level?? What do you suggest?

  6. I recently went thru menopause and since then I’ve noticed vaginal dryness when having intercourse…how can I remedy this without take any hormones

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