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What is the ThermiVa®?

ThermiVa® is a non-surgical, safe and effective procedure that uses radiofrequency heat to tighten loose, sagging skin and increase blood flow and nerve sensitivity in the vaginal area.

What are the benefits of the ThermiVa®?

  • Vaginal and labial laxity
  • Vaginal dryness
  • Urinary incontinence and overactive bladder
  • Painful sex

How is it performed?
During the procedure, a small wand is slowly moved over the areas of concern, gradually heating the tissue.  The procedure takes less than an hour, during which most women report feeling only a warm sensation and no pain.  There is no down time once completed, women can return to exercise and sexual activity immediately.

What is the O-Shot®?
The O-Shot® is a non-surgical, minimally invasive procedure that can help improve a woman’s sexual desire and orgasm, decrease urinary incontinence and treat a chronic skin condition called lichen sclerosus.   Up to half of women experience low sexual desire and many others experience issues with arousal, lubrication and orgasm.  The O-Shot® uses platelet-rich plasma (PRP) that contains growth factors from the woman’s own blood, and is injected into the clitoris and vaginal wall.  This increases the blood flow, nerve sensitivity and collagen formation in the area, leading to improved sexual function.

What are the benefits of the O-Shot®?
This injection can increase a woman’s sexual desire and arousal, as well as improve the number or quality of her orgasms.  In addition, this procedure can help with

  • Leaking urine
  • Painful sex
  • Vaginal dryness
  • Decrease symptoms and long-term consequences of lichen sclerosus

How is it performed?

Blood is drawn from the patient and then using a special double-spin process the red blood cells are removed, leaving the plasma which is full of growth factors.  Numbing cream is then placed onto the areas that will be injected, and a lidocaine injection is performed to ensure there is minimal to no discomfort during the procedure.  The PRP is then injected into the clitoris and vaginal wall.  The procedure takes less than an hour.

If you would like to learn more about these procedures, schedule a consultation with one of our Women’s Health providers.



In celebration of National Condom Week (4/14-4/21), a reminder about the importance of safe sex is due.   Last year, the CDC reported that rates of Syphilis, Chlamydia, and Gonorrhea in the U.S. had all increased for the fourth straight year.  Forty-five per cent of the new Chlamydia cases were found in young women—a particularly alarming statistic, as this infection can lead to infertility if unrecognized/untreated.  Genital herpes is estimated to have a prevalence of 1 in 6 Americans, with women far outnumbering men in new cases.  And the HPV virus, as we all know, can lead to cervical dysphasia and even cancer in infected women.   All of this points to the importance of awareness and preventive measures in limiting the spread of various sexually-transmitted infections.   First of all—know your/your partner’s risks. Higher-risk populations for contracting STIs include men who have sex with men (MSM), those with new or multiple sexual partners, those who live in an area of high STI prevalence, and those who exchange sex for drugs or money.   Second—consider preventive measures you/your partner can take before you become sexually active.  The HPV vaccine series has proven very effective in reducing infections with the viral strains that the vaccine is designed to prevent.   Hepatitis B infection can also be prevented though vaccination.  Individuals with genital herpes can reduce the likelihood of transmitting the virus to their partners by taking a daily suppressive medication.  And certain high-risk individuals can take pre-exposure antiretroviral prophylactic (PREP) medication regularly to ward off acquiring HIV from an infected partner.  If you do decide to become sexually active, using condoms consistently and getting tested regularly are paramount.  Condoms are not 100% effective at preventing STIs, so the importance of regular screening cannot be underestimated—be safe!



Certainly, if you have a cold or the flu, I would not recommend exercising.  Patients ask all the time, “can I still exercise, even though I am sick?”  Keep in mind, most infections are viral, and part of treating a viral infection includes rest.  Even if you have a bacterial infection, it is best to rest, because no matter what is causing the infection, you are always dehydrated and exercise is going to make this worse which makes your recovery harder.

Asthma is caused by your body reacting to outside elements or allergens.  Extreme weather is never good for exercising, but if you keep a few things in mind you may be able to exercise without causing an asthma flare.

In the winter the air is colder and drier typically.  When you are breathing in this heavier air you may notice that your lungs burn. Normally there is a small layer of mucus in your lungs that keeps things in check, but if you are breathing in the cold dry air, that small layer of moisture evaporates and in turn you experience that burning feeling.  Breathing in the cold dry air takes more of an effort for your body and it can trigger a histamine reaction, which is similar to what happens when your lungs are exposed to allergens.  The histamine reaction will cause your body to produce more mucus which in turn makes your airways smaller and makes it harder to move air. Increased mucus can also make you to be more susceptible to getting infections.

Keeping all of this in mind, it is recommended that you try to breathe through your nose as much as possible and try to make the air that you are taking in more moist by either wearing a mask or breathing through a scarf.  Breathing through your nose also helps your body combat infections, because you have little hairs in your nasal area that will kick out microbes to keep you healthy.  Make sure you are well hydrated at all times which also helps to keeps the germs to a minimum.  It is also helpful to use your rescue inhaler 15-30 minutes before you exercise.

Additional things to keep your asthma stable during the winter would include getting a flu shot, avoiding sick contacts if possible, washing your hands often, vacuuming/dusting frequently and washings sheets and blankets in hot water once a week. Asthmatics are more prone to asthma attacks when they get sick, so taking precautions to not get sick go a long way.  I am also a big proponent of 500 mg of Vitamin C in the winter to help avoid getting sick.  But remember, if you do get sick, give your body the rest it needs to recover quickly and avoid exercise.


03/Jan/2019

The thyroid is a small, butterfly shaped gland that sits at the base of your throat. Don’t be fooled by its diminutive size. The thyroid is actually the general that directs the function of many parts of your body, as well as your major organs.  The thyroid produces thyroid hormone, which it makes all on its own from the iodine consumed in your diet. Directions on when and how much hormone to release comes from the commander in chief: the pituitary gland. Making sure that your thyroid is able to produce the hormone and distribute it to your cells properly is more important than most people think.

Sometimes an illness, medications, damage to your thyroid, or even age can change the function of your thyroid. That’s why your doctor usually includes thyroid testing in your annual blood work. If you have too little hormone and it is not being sent out to your cells, it is called HYPOthyroidism. When this happens, everything slows down. You may feel tired, depressed, cold or even start to gain weight even though you have not changed your diet or exercise routine. It is not unusual for menopausal women to require thyroid medication to boost production and distribution of thyroid hormone. Synthroid (levothyroxine) is a safe medication with very few side effects that women can take daily with little concern.

When your thyroid is not producing enough hormone, it gets signals that it is under- producing and starts to work harder. Sometimes this can result in an enlarged gland that is called a goiter. This is much less common than it used to be because so many foods are iodine-enriched, making sure that a normal diet is adequate to provide needed amounts of iodine to produce thyroid hormone. Even so, it is very important to have your levels checked every year to prevent the stress on the thyroid. If you see or feel a bump near your thyroid, see your doctor for an evaluation.

The other side of the coin is HYPERthyroidism. This is when your thyroid is turbo-charged and produces way more hormone than you need. You may feel anxious, with a racing heart, have trouble sleeping and lose more weight than you’d like. The autoimmune disorder, Grave’s disease, is the most common cause of hyperthyroidism. With Graves, your own antibodies see the thyroid as foreign and attack it. This causes the thyroid to overproduce hormone. There are a number of medications that can help to slow things down. There are also treatments and finally, surgical removal of the thyroid. Only your doctor can tell you which is best for you.



Happy 2019!  As we run, walk, or maybe even crawl into the New Year, we often begin with a desire, if not a definitive plan to make lifestyle improvements.  Once and for all, we’re going to tackle that cluttered home, lose those extra pounds, or find the career where we’ll truly find fulfillment.  Despite our good intentions, we may quickly find ourselves overwhelmed and frustrated as we set lofty and often unrealistic goals.  Without a thorough assessment of our needs, wants, and resources, we can often fail to achieve our intended lifestyle improvements.  The New Year offers an excellent opportunity for a fresh start and a reexamination of our goals and choices.  As we begin 2019, I encourage you to look at your life with a critical eye and decide what you need to, want to, and are willing to try to work to improve.  Here are 19 suggestions for 2019 that can help.  Through these, you can improve your chances of lifestyle balance, goal achievement and of living the life you want and deserve.

1) Spend some time alone.  Get to know yourself without the influence of others.  You might find you like your own company.

2) Learn and practice Mindfulness.  Work on being in the present rather than allowing yourself to dwell in the past or anticipate the future.

3) Set boundaries with others, be they family, friends or coworkers.  Do not accept disrespect.

4) Allow others to help you.  They’ll feel good and you may get some much needed relief.

5) Get up and move!  Take the stairs, go for a brisk walk, do some jumping jacks, practice yoga, ride your bike.  Find a way to move your body.  Simply moving briskly 20 minutes each day can help decrease anxiety, depression and relieve stress.

6) Don’t be so hard on yourself if you don’t accomplish everything you planned each day.  No one does.  Work on small, realistic, attainable daily goals.  Small achievements reinforce us, leading us to want to strive for more.

7) Help someone else.  You’ll feel good and they may get some much needed relief.

8) Surround yourself with supportive and loving people.  Make good choices about with whom you choose to share your world.

9) Work on clearing away physical clutter.  You’ll be amazed at how this can lead to increased productivity and decreased anxiety.

10) Decide what changes will make you the happiest in the coming year.  Prioritize those.

11) Give yourself a time out.  When you feel overwhelmed, take 10 minutes alone to regroup.  Close your eyes and breathe.

12) Stop comparing your life, body, career, children, house, relationship, etc., to others.  You are a unique individual and deserve to be treated as such.

13) Look for opportunities to enhance parts of your life you never considered.  Read more.  Learn an instrument.  Take a break from social media.  Volunteer.

14) Share your intentions to improve your life with someone.  You’re more likely to achieve goals when you tell someone else.

15) Take risks but don’t be careless.

16) Let go of regret and grudges.  These simply expend energy unnecessarily and increase stress.

17) Have high expectations of others, both personally and professionally.

18) Be honest about your present circumstances.  If you’re feeling anxious and depressed, seek help.

19) Finally, as the great Maya Angelou said, “My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor and some style.”  Let’s all seek to do the same in the New Year.

Best wishes for a wonderful 2019!



We all know that winter time can be joyful and cozy. However, this time of year can also be accompanied by frequent illnesses, extra stress, and overindulgences. To protect yourself this holiday season, we recommend the following:

1)  Wash your hands!!! Yes, it seems obvious, but it’s all too easy to forget. This simple action, when done right, can protect you against many respiratory and diarrheal infections. Wet your hands under running water, lather up with soap, and scrub your hands (including the backs, under nails, and between your fingers) for at least 20 seconds, or for the length of time that it takes you to hum/sing the “Happy Birthday” song twice. Wash your hands before and after you handle food, before eating, before and after you care for a sick individual, after using the bathroom or changing a diaper, after blowing your nose/coughing/sneezing, after touching garbage, and after handling pets/pet food/pet waste. If you are interested in the science behind handwashing, please check out the CDC’s website here: https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html

2)  Get your flu shot. The science behind the flu shot is robust. Getting your yearly vaccination can help avoid flu-related hospitalizations, illnesses, and transmitting the flu to others who are unable to obtain the vaccine (infants under 6 months or those with severe, life-threatening reactions to the flu vaccine).

3)  Aim for a regular sleep schedule, and if possible for 7-8 hours of sleep every night.

4)  Stay well hydrated- ideally (unless you have other significant medical conditions such as heart failure) aiming for about 6-8 glasses of water a day.

5)  Make sure you are aiming for those 4-5 fruits and vegetables a day, even during special occasions. If you overindulge, don’t beat yourself up, but aim for healthier, well balanced meal options in general.

6)  Be cautious with alcohol intake. We recommend no more than 7 drinks per week in women, and specifically no more than 2-3 drinks per day.

7)  Avoid contact with individuals that are sick to the best of your ability, and as above- make sure you wash your hands frequently to avoid spreading germs.

8)  Take time out for yourself to decompress; this may mean yoga, meditation, therapy, reading a good book, watching your favorite TV show, exercising, etc. Self-care and mindfulness is important.



‘Tis the season for lots of cookies, cakes, creamy drinks, hearty meals and overall indulgence!  This is the time of year when you are faced with more temptation than ever. Let’s take a few moments to think about how you can maintain your health while still enjoying the season:

1. Remember that balance is everything! 
Follow the 80/20 rule. This means that 80% of the time you will eat as healthily as usual and 20% of the time you will let yourself enjoy a treat without guilt. Here is some math: There are 40 days and 120 meals between Thanksgiving and New Years. If you follow the 80/20 rule you can have a treat at 24 of those meals. Choose wisely and consider tracking on your calendar. You may find that you can’t resist indulging at one event but you have no problem at another. Skip the donuts and leftover pies at work and save your 24 for a dinner or a party!

2. “Indulge” with these healthy but tasty treats:
A) Dip your vegetables in something creamy…. Make a savory dip with plain Greek yogurt!  For a thicker consistency, strain the yogurt overnight over a cheesecloth to remove liquid, then mix the thickened yogurt with your favorite savory seasoning and top with fresh chives or scallions. (Tip: you can use Greek yogurt as a substitute for many recipes that call for cream or sour cream).

B) Fill your house with the warm smell of baked apples and cinnamon: Slice apples in half or in to bite sized pieces. Coat with a small amount of coconut oil and cinnamon to taste. Optional: Sprinkle with almond slivers. Bake in the oven at 350F 20-30 minutes.

C) Try making “cookie dough” balls with chickpeas! Blend together chickpeas, nut butter and a small amount of honey. Your goal is a cookie dough consistency. Toss in some chocolate chips and roll the “dough” in to bite sized balls. You can eat this raw or you can bake it to get the melted chocolate effect!

3. Ask yourself, is this making me healthy? Is it making me happy?
If the answer is neither, why are you eating it? When was the last time somebody offered you a cookie and you took one bite and thought “this isn’t very good” but kept eating it anyway? This season challenge yourself to put the not-so-tasty cookie down! Save your 24 for something worthwhile!

4. Choose this not that:
A) Choose an apple crumble instead of an apple pie
B) Choose grilled, braised or roasted instead of stuffed, smothered, or rich
C) Instead of randomly grazing at a party, choose one item you can’t resist and then fill the rest of your plate with protein and produce



Hormonal contraceptives offer women of all age’s protection against unintended pregnancies through suppression of ovulation, thinning of the uterine endometrium, and/or inhibition of sperm motility and decreased sperm dispersion through the cervical canal and into the ovum. Many reliable, effective, and safe contraceptives are available for women, including long-acting reversible contraception (LARC) for women who are not candidates for estrogen-containing birth control or who prefer continuous protection for extended intervals.

Hormonal IUCs release progestin, a synthetic version of the hormone progesterone. The levonorgestrel impregnated IUC releases progestin into the uterine cavity, thickening cervical mucous, and causing thinning of the lining of the endometrium. There are four approved devices in the U.S., to include the Mirena, Kyleena, Skyla and Liletta. These are small, plastic, T-shaped contraceptives, that are placed inside the uterus and prevent pregnancy more than 99% of the time. The progestin IUCs start working about seven days after insertion and may be left in place, depending on the type, from three to seven years. All are inserted by a trained healthcare professional and can easily be removed at any time. At RWWC, we currently have both the Liletta and the Kyleena.

Liletta slowly releases 52 mg of a progestin hormone called levonorgestrel. This is the same kind of hormone that is often used in birth control pills. Only a small amount of levonorgestrel enters your bloodstream. Neither the Liletta nor the Kyleena contain estrogen. Approved for use in the U.S. in 2015, it measures 32 mm x 32 mm. Kyleena, approved in 2016, contains 19.5 mg of levonorgestrel and measures 28 mm x 30 mm. It works the same way as the other progestin containing IUCs, slowly releasing levonorgestrel over time. Both are effective against unintended pregnancies for up to five years.

The Copper-T 380A IUD (intrauterine device) was introduced into the United States in the late 1980’s. It is a small, (36mm vertically x 32mm horizontally) plastic “T” shaped contraceptive placed in the uterus by a trained health care professional. The approved duration for use of the Copper IUC is twelve years. Otherwise known by the brand name Paragard, this IUC is the only nonhormonal IUC approved for use in the U.S. Paragard does not contain hormones, instead using the copper that surrounds it to halt sperm from getting to the egg as well as possibly creating an immune response within the reproductive tract that interferes with fertility before an egg reaches the uterus. IUCs prevent fertilization but are not abortifacients, which had been a common myth. The Paragard IUC works as soon as it is placed inside the uterus and can be used for emergency contraception if inserted within five days after unprotected intercourse. The Paragard is easily removed whenever you want and is safe to use while breastfeeding. Common side effects after placement include heavier periods and cramping for several months, both alleviated with over the counter non-steroidal anti-inflammatories (NSAIDs) like ibuprofen. We do offer the Paragard IUC at RWWC.

Hormonal contraception also offers many health benefits besides prevention of an unintended pregnancy. The hormonal intrauterine contraceptive (IUC) may reduce the risk of some cancers, including cancer of the endometrium (the lining of the uterus), cervical, ovarian, and even colon cancer. Many women benefit from menstrual regulation and decreased cramping, while others have a lighter period-or no period at all. Both the hormonal and non-hormonal IUCs are over 99 percent effective, cost-effective, long-lasting, and decrease the possibility of user error that comes with taking a pill every day or using condoms.

There are a few risks involved with the IUCs, as well as contraindications, that should be discussed with your healthcare provider prior to insertion. Please schedule a consult beforehand, if you have not already discussed the appropriateness of IUCs at your annual gynecologic visit. Problems can be managed, and most women are happy with their choice. Continuation rates for intrauterine contraceptives are generally higher vs. other forms of contraception for women.­

We also offer Nexplanon. The Nexplanon is considered a contraceptive implant – it is a very small rod inserted under the skin of a woman’s upper arm to provide birth control. It’s invisible and prevents pregnancy for up to 4 years.



Even though I am a city girl at heart, I have to admit there are some good things about living in the country.  I grew up in the suburbs (my parents hated the city) and once I went to college in the city, I never left.  The biggest thing I miss is sitting outside in the summer, staring up at the sky and listening to the sounds of nature.  But this isn’t about me – so I would like to present the pros and cons of city vs suburban living.

City life provides more options for anything you need at a moment’s notice. This can be a great thing, unless you have a hard time making decisions.  The city offers multiple choices for essential things like different health systems as well as less important things that only seem essential like coffee shops.  Sometimes finding alternative foods when you have food allergies/sensitivities may be more cumbersome in the country – while it is easier to find local produce in the country. However you may be lucky enough to have access to an open market in the city where you can get locally grown products.

The landscape of where you live does not discriminate on the types of sicknesses you can catch. Believe it or not, you can still get Lyme disease in a city.  On the other hand, if you need medication or help from a neighbor, these things are more accessible in the city.  Frequently there are fewer choices for medical specialists in the country and patients may need to travel further to get better care.  Equally you can spend a lot of time in a car travelling from one point of the city to another or from one town to the next.  Pick your poison.

Typically the city offers more resources in every category – whether you are considering a psychotherapist, yoga studio or the best French bakery.  Often times the hours are more flexible/longer in a city which makes it more accommodating for working people.  But sometimes, because people are more likely to know each other better in the country, people may be more likely to be to help out.  Have you ever tried stopping someone in the city to ask for help or ask a question?

One big advantage to living in the country would be larger living spaces and more green space.  This allows for kids, adults, pets and dogs to roam around.  Generally the trend is that you get more bang for your buck when it comes to housing.  The space that the country provides creates a lot of possibilities for your property, like a pool! Who doesn’t love that in the summer?

There are more employment options in the city, but often times the employer is more likely to be larger in size which has its own set of pros and cons.  On the flip side, sometimes in a smaller entity, it may be easier to communicate and achieve your task.  You can get lost in a large group, but smaller employment groups may be stifling.

The city comes with a lot of action. Entertainment, culture and groundbreaking events are more likely to occur in the city.  For someone that does not like crowds, traffic or noise, the city may not be for them.  Violence tends to be more prominent in cities. Some upkeep is questionable –  having tripped and fractured my elbow three years ago, I would always be aware of uneven payments when walking around on any side walk, especially in Philadelphia.

With more cars, buses and trucks come more pollution.  When it is windy/cold the city may be a few degrees warmer and less likely to have roads covered in snow.  Smaller city streets make it harder to clear away snow when there is a large accumulation.  Parking can be a challenge in the city.  City dwellers do tend to walk a lot in comparison to people living in the county, but at times whether it is for work or a consequence of where someone is living, people in the country may need to walk more to get somewhere on their property or to get to work if they do not own a car.

It is difficult deciding where to live when you are just taking yourself into consideration and the variables grow exponentially when making the right decision for a spouse or family.  There are a lot of things to consider when choosing where to call home. Some are lucky enough to live close to the comforts of a city with the positive attributes of residing in the country.  The best option is what fits best for the individual or family.


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1632 Pine Street
Philadelphia, PA 19103
Phone: 215-735-7992
Fax: 215-735-7991
Email: info@rwwc.com

Hours

Monday – Friday:  8am – 8pm

Saturday: 9am – 2pm

Sunday: Closed

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