Mona Lisa Touch

It is estimated that more than 50% of women experience the bothersome symptoms of vaginal atrophy (thinning) caused by the decline in estrogen levels during the perimenopause (the menopausal transition) and menopause.  These symptoms include vaginal dryness, burning and itching, painful intercourse, and painful urination.  It is also estimated that 60% of women affected by cancer suffer these symptoms during or after cancer therapy.

MonaLisa Touch^R is a safe, effective, non-surgical, in-office treatment that uses a controlled CO2 fractional laser. It has been available in the U.S. since 2014. The laser energy is designed to revitalize the vagina by stimulating cells in the vagina to produce collagen to restore the integrity of the vaginal walls.  It also stimulates the formation of new blood vessels, so blood flow to the vaginal walls is improved. These results increase vaginal sensitivity and lubrication while also providing the feeling of a tighter vagina.  Although not originally used for urinary symptoms, a documented beneficial side effect of MonaLisa Touch^R laser therapy is the improvement of stress urinary incontinence.

The MonaLisa  Touch^R vaginal laser therapy is a series of 3 short treatments (about 10 minutes each) spaced 6 weeks apart (more treatments may be needed for lichen sclerosus).  No anesthesia or pain medication is required during or after the procedure.  Many patients report the laser feeling like a gentle vibration. Some women experience improvement after the first treatment, however best results occur after 3.  While improvement can be long-term, some women elect to have a touch-up every 12-18 months as maintenance.

MonaLisa Touch^R laser therapy is also used to treat lichen sclerosus of the vulva.  Lichen sclerosus is a chronic autoimmune skin disorder of the vulva that causes intense inflammation, itching, burning, and pain.  In addition, lichen sclerosus causes vulvar scarring, which may, in turn, cause significant sexual dysfunction and/or pain.  Lastly, about 6% of women with lichen sclerosus will develop vulvar cancer.  The current “gold standard” treatment for lichen sclerosus is potent steroid creams.  When used correctly, steroid creams help decrease the itching and burning and suppress underlying inflammation.  However, steroid creams used long-term may have serious side effects, including thinning of the vulvar skin, superimposed infections, rebound dermatitis, and adrenal insufficiency.  Due to these side effects, it may be inadvisable to use steroid cream to treat lichen sclerosus for a prolonged period of time.  MonaLisa Touch^R laser therapy is a safe alternative intervention. 

How is the MonaLisa Touch^R laser therapy done?

A  cylindrical probe is gently inserted into the vagina up to the apex, and the laser therapy is performed by rotating the probe 360^O as it is slowly retracted in increments of 1 cm (about a half inch), thereby allowing the vagina to be treated on multiple levels.  Again, no anesthesia or pain medication is required.  Most women do not feel anything after the procedure, but some may experience some mild side effects such as general vaginal soreness or discomfort, mild spotting, a brown or pink watery discharge, or slight burning with urination.  Normal activities can be resumed immediately, but sexual intercourse may only be resumed after two days.

A different probe is utilized when using MonaLisa Touch^R laser therapy for lichen sclerosus of the vulva, and in this setting, a topical anesthetic cream is applied prior to the procedure.

In summary:

• MonaLisa Touch^R laser therapy increases vaginal lubrication and decreases pain with sexual intercourse
• MonaLisa Touch^R laser therapy restores tightness, sensitivity, and functionality of the vagina
• MonaLisa Touch^R laser therapy treats many of the other bothersome symptoms of vaginal atrophy, including urinary incontinence
• There is no down time following MonaLisa Touch^R vaginal laser therapy
• Women can resume sexual activity quickly following MonaLisa Touch^R vaginal laser therapy
• MonaLisa Touch^R laser therapy can also be used to treat lichen sclerosus, a chronic disorder of the vulva
• MonaLisa Touch^R laser therapy can improve a woman’s quality of life

It is important to note that, presently, health insurance does not cover this treatment.  MonaLisa Touch^R laser therapy is considered an “elective” treatment.