Tucson, AZ 520-783-7184

3170 N Swan Rd #110, Tucson, AZ 85712

What’s Going On Down There?

Conveniently located to serve Tucson, AZ

woman body

With aging comes changes in a woman’s body. Vaginal moisture can diminish and the vagina can feel dry and rough, and cause discomfort. The changes in our bodies and our sexuality are a less than welcome surprise for many women. We assumed that with menopause came the dreaded hot flashes but most of us didn’t realize all the other changes involved in “the change”! With the decrease in estrogen, especially during the perimenopause and after menopause, the vaginal tissues can become thin and pale and dry and easily irritated. Intercourse can become painful and avoided. Over the counter lubricants sometimes are not enough to make sex comfortable and pleasurable again. The normally acidic pH of the vagina changes and a woman can be more prone to infections. On top of this, many women may experience a decrease in libido as sex hormones start to wane during the perimenopause and menopause.

In addition to the body’s changes from the diminishing hormones with aging, many women suffer from vaginal laxity, and to make matters worse, one in three women have some complaints of involuntary leakage of urine. Having some leakage while coughing or sneezing or making rapid movements, such as Zumba or jogging plagues many women who figure they are unique in this malady, and who often suffer in silence. This condition tends to worsen over time if not addressed. Vaginal laxity is common, as is laxity of the pelvic floor which can lead to pelvic prolapse, pain and debility. All of this can contribute to decreased sensation and response and enjoyment of a woman’s and a couple’s sex life. Add to this the changes many men go through with aging, and their diminishing testosterone levels, and it’s a perfect storm for sex and intimacy to go by the wayside.

Aging gracefully and in comfort during middle age and beyond, and maintaining a fun and fulfilling sex life were not part of the conversation many of us grew up with. These changes can be very unsettling and women often don’t know how or who to talk with about this, or where to go for help. Many women say they have spoken with their gynecologists to be told “this is a natural occurrence” but have not been offered any satisfactory solutions on how to remedy the problems of vaginal dryness, lack of libido, painful intercourse or leakage of urine. Women are so relieved when this subject is approached. No more silence. No shame. It’s an open and affirming and healthy conversation that begins here.

Starting with an assessment done by our highly experienced and compassionate GYN providers we can tailor a program to help you stay comfortable and healthy. Mild to moderate leakage (stress incontinence) can be addressed easily. YES, we can help you get your sexy back. We are living longer and better and it is quite possible to maintain a healthy sex life throughout life and to hold back the uncomfortable changes associated with the aging process. The Tula vaginal rejuvenation program has a number of different approaches. Starting with scheduling a consult and an exam, women can speak freely and in confidence that they will be heard with a compassionate ear and that their problems will be addressed. Our female providers understand the importance of listening to women and empathize with our clients’ passion to stay healthy and vital and sensual.

We have had tremendous success with ThermiVa treatments! ThermiVa is a painless and gentle heat treatment using radiofrequency waves. The tissues of the vulva and vagina are gently heated in a series of three treatments, each a month apart. There is no downtime and women with mild to moderate stress incontinence can expect a reduction or cessation of symptoms for up to a year. The treatment requires a touch up at that time. ThermiVa is wonderful in helping regain vaginal moisture, helping with tightening the labia and tissues of the vulva and vagina, remedying mild to moderate stress incontinence, and increasing sexual response and orgasm.

Systemic hormone therapy, using bioidentical estrogen and progesterone, and sometimes testosterone as well, can help greatly with libido and dryness. These can be done via a patch or a troche (lozenge) or a cream that is applied to inner arm or leg. Many women also benefit from the addition of a gel or cream used vaginally to help re-estrogenize the tissue and improve and maintain moisture. The addition of a small amount of testosterone to these vaginal hormones can help with libido and can also help with muscular contractility, which aids with response and orgasm. Some women may also need the addition of pelvic floor physiotherapy to help with pelvic floor dysfunction. A vaginal rejuvenation plan is always tailored to the individual, and varies depending on a woman’s condition and her response to treatment.

We carry a full line of high quality dilators, kegel exercisers, and sex toys from top of the line Jimmie Jane, Lelo and Fun Factory. We pride ourselves in providing a healthy-sexuality affirming sex-positive, women’s oasis at Tula. Our providers are comfortable listening to your concerns and answering your questions. You will be treated with respect and honored.

It is quite possible to maintain romance, passion and a satisfying sex life as we age. It is easy, with some medical help, to maintain a healthy and moist vagina throughout our life and to eliminate the discomforts that used to be considered inevitable with menopause. It is not necessary to suffer in silence with mild to moderate stress incontinence or to resort to painful, and often unsuccessful, surgery for this.

It’s wonderful to see how well people respond to these treatments and to hear their testimonials of increased comfort and joy. We can help.

Dr. Arianna is the only provider in Tucson who has all of the different modalities for vaginal rejuvenation

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Your What’s Going On Down There? will be performed in Dr. Arianna Sholes-Douglas' wellness center located in Tucson, AZ.

Real Patient Testimonials





What an incredible experience so far! I am 2 sessions into the Intimacy Wellness package recommended by Dr. Sholes and it has made all the difference in the world. You can turn back the clock of time and feel young again! Thanks to the team at Tula Wellness & Aesthetics and I’m grateful for your knowledge and expertise!