Pelvic Laser Therapies
As women age, many experience unwanted symptoms associated with menopause due to collagen loss and estrogen decrease. Among the most common are vaginal dryness and pain during physical intimacy. Women may also have more urinary tract infections, or UTIs, and urinary incontinence. The MonaLisa Touch™ laser is a treatment to address the genitourinary symptoms of menopause, including pain during intimacy, called dyspareunia, and vulvovaginal atrophy, or dryness.
MonaLisa Touch, a fractionated CO2 laser treatment, is much like your annual exam. It is a quick, in-office procedure that only requires prescription-strength topical anesthesia, produces minimal discomfort and is free of hormones. MonaLisa Touch treats the underlying causes and not just the symptoms of menopausal changes. It stimulates collagen growth and blood flow, resulting in improved elasticity, hydration and functionality.
What is menopause?
Menopause is a natural life-changing event for women. It is defined as the end of menstruation or more specifically, an entire year without menstruation. The age of menopause onset varies greatly. The average age of menopause in the US is 51, but it can occur anywhere between 40 and 60. Some women experience medically or surgically-induced menopause, caused by removal of the ovaries, chemotherapy, radiation or hormonal therapy, which are common treatments for breast cancer.
What are menopause symptoms?
The symptoms of menopause can be unpleasant and life-changing. When a woman reaches 40 or 50, her estrogen decreases. This can affect the vagina, vulva, uterus, breasts, bones, brain, skin, hair, heart, blood vessels, bladder, urethra and mucous membranes. Menopause symptoms include:
- Hot flashes and night sweats
- Mood swings and irritability
- Memory or concentration problems
- Vaginal atrophy or dryness
- Painful intimacy, known as dyspareunia
- Itching and burning
- Heavy bleeding
- Hair changes
- Heart palpitations
- Sexual disinterest
- Urinary changes
- Weight gain
What causes estrogen decline?
- Menopause, which is the most common cause
- During breast-feeding
- After removal of ovaries
- After chemotherapy for cancer
- Following pelvic radiation for cancer
- After hormonal therapy for breast cancer
- Medications for hormone-receptive breast cancer
What are vaginal atrophy and dyspareunia?
Vaginal atrophy (dryness) and dyspareunia (painful intimacy) can occur from estrogen decline. The vaginal epithelium, which is the organ’s inner lining, loses elasticity and blood supply, causing it to thin and lose moisture. It can become fragile and susceptible to injury. As a result, a woman may experience urinary incontinence, dryness, painful intimacy, itchiness, burning, prolapse and vaginal laxity or looseness. These are symptoms of the genitourinary syndrome of menopause.
Menopause symptoms are often ignored because women are reluctant to talk about them. Also, there has been a lack of non-invasive treatments. Now, with MonaLisa Touch, women can be treated easily and conveniently in their physician’s office. With its gentle action and taking just a few minutes, the procedure is well-tolerated by the vulva at no risk to surrounding tissue and organs.
MonaLisa Touch has been clinically tested and found to be effective, with most patients experiencing substantial relief from menopause symptoms such as dryness and dyspareunia. Patients say the MonaLisa Touch improves hydration and comfort during intimacy. Because symptoms may gradually return as women age, an annual touch up is recommended to maintain results. Individual outcomes may vary.
What about hormone replacement therapy?
HRT, hormone replacement therapy, can relieve the symptoms of dryness and painful intimacy by boosting estrogen levels enough to reverse these changes. Short-term usage of HRT carries little risk. Local vaginal HRT can be used long term. Some alternatives to HRT include lubricants, moisturizers, herbs, exercise, and acupuncture. Alternatively, the MonaLisa Touch laser is FDA-approved as a safe, effective treatment for symptoms and has shown similar improvement to vaginal hormone therapy. Hormone-free, MonaLisa Touch can be used by women who have been treated with chemotherapy, radiation and/or hormonal therapy for breast cancer. As with any anti-aging treatment, individual results may vary.
How does the MonaLisa Touch work?
MonaLisa Touch is gentle, non-invasive and only requires prescription-strength topical anesthesia. A probe is inserted to deliver to deliver CO2 fractional laser energy to the surface layer of the vagina. This increases blood flow and stimulates collagen growth, improving moisture and hydration without lubricants and hormones. Patients can return to normal activity following a treatment session.
Noticeable results can occur after only one session, with three sessions usually needed for full effectiveness. Depending on the severity of their condition, some patients may require four to five treatments. Sessions are 30 minutes long and are scheduled six weeks apart. An annual touch-up is recommended for maintenance, because otherwise symptoms will gradually return due to the aging process. A yearly touch-up protects your initial investment by preventing the need to repeat all three treatments. Individual results may vary.
Who is the MonaLisa Touch laser treatment for?
Candidates for the MonaLisa Touch laser treatment include:
- Women wishing to avoid hormone replacement therapy (HRT) but who are experiencing vaginal atrophy, or dryness, and / or pain during intimacy, called dyspareunia
- Patients with a history of breast cancer, thrombophlebitis or other contraindications to estrogen
- Women who have not responded well to local estrogen treatment
- Those wishing to return to pre-menopausal health
- Female to male transgender patients experiencing atrophy
- While most women are candidates for MonaLisa Touch, it is not recommended for women with active infections, such as candidiasis and herpes genitalis; those with undiagnosed lesions; during or three months after pregnancy; women with a history of radiation to the treatment area; and those who have had reconstructive pelvic surgery with mesh kits.
- Caution is recommended for women with a TVT-type sling for incontinence, but it is not a contraindication.
What indications or symptoms can the MonaLisa Touch treat?
- Painful intimacy, (known as dyspareunia)
- Dryness and discomfort
- Burning and itching
- Weakness and laxity
- Stress or mild urinary incontinence
Can the MonaLisa Touch laser be used to treat lichen sclerosus?
Lichen sclerosus is an autoimmune disease whose cause is not known. It can occur in females as young as seven and up to 60, presenting as white patches on the skin around the vulva, resulting in itching contributing to dyspareunia. Lichen sclerosus is not contagious, but flare-ups can be very distressing. Although the cause of lichen sclerosus is unknown, risk factors may include:
- Autoimmune conditions
- Skin changes
Evidence shows that MonaLisa Touch laser therapy used externally on the vulvar tissue can improve and relieve symptoms. Five or more sessions are needed, but patients may see some improvements as early as early as the third treatment. Just as with any chronic condition, regular laser treatments are necessary to manage symptoms. Individual results may vary.
Treatment instructions for the MonaLisa Touch laser
Refrain from sexual intimacy 24 hours prior to your treatment. Avoid the use of lubricants or creams 48 hours before treatment.
Refrain from sexual intimacy for 48 hours following treatment. Most patients resume other normal activity as tolerated immediately after the procedure.
Scientific publications about the MonaLisa Touch laser
- Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study. S. Salvatore et al. Menopause 2015 Jan 20. doi: 10.1097/GME.0000000000000401. [Epub ahead of print]
- Vulvo-vaginal atrophy: A new treatment modality using thermo-ablative fractional CO2 laser. A. Perino et al. Maturitas. 2015 Mar; 80(3):296-301. doi: 10.1016/j.maturitas.2014.12.006. Epub 2014 Dec 25
- Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. S. Salvatore et al. Climacteric 2014 Dec 16. doi:10.3109/13697137.2014.975197 [Epub ahead of print]
- Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. N. Zerbinati et al. Lasers Med Sci 2015 Jan, Vol. 30, No. 1:429-36. doi: 10.1007/s10103-014-1677-2. Epub 2014 Nov 20.
- Microablative fractional CO2 laser improves dyspareunia related to vulvovaginal atrophy: a pilot study. S. Salvatore et al. Journal of Endometriosis and Pelvic Pain Disorders 2014. DOI:10.5301/je.5000184. Epub 2014 Jun 20.
- A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. S. Salvatore et al. Climacteric Aug 2014, Vol. 17, No. 4:363-369. doi: 10.3109/13697137.2014.899347. Epub 2014 Jun 5.
SoLa Therapy is a revolutionary new laser treatment for chronic pelvic pain, providing relief in as little as two weeks. It uses light energy to stimulate the mitochondria, which power cells, to help promote healing. This process is called photo biomodulation or PBM. It is different than other treatment methods for pelvic pain because it stimulates the natural healing process rather than simply masking the pain.
How SoLa Therapy works
Muscle relaxation: The gentle SoLa laser soothes and relaxes muscles that have contracted due to chronic pelvic pain, increasing discomfort.
Promotion of healing: Stimulates oxygen delivery to the affected area, helping to drain toxins and increase blood flow.
Cellular photo biomodulation: Increases the production of cellular modulators, or agents, necessary for healing and pain relief.
Conditions SoLa Treats
Many factors and conditions can cause pelvic pain. SoLa Therapy is approved for treating:
- Dyspareunia, or pain with intercourse
- Levator, or muscle-based pelvic pain
- Bladder pain syndrome
- Interstitial cystitis
- Vulvodynia, or chronic pain, burning or irritation around the vaginal opening
- Other conditions may also benefit from this treatment. Consult with your physician to determine if this is the right treatment for you.
How SoLa Therapy is performed
SoLa is similar to a pelvic exam. A thin wand is inserted internally and placed into the pelvic muscles. There may be a warming sensation but there should not be any pain. The treatment takes just a few minutes and each appointment in total is about 15 minutes long.
Benefits of SoLa include:
- Convenient in-office procedure
- Pain free or mild discomfort
- Doesn’t require anesthesia
- No side effects
- Treatment takes less than five minutes
How many treatments are needed?
Each patient is evaluated to determine how many treatments will achieve the maximum results. Generally, you should expect three sessions three times a week for three weeks, for a total of nine treatments.
How soon can I expect results?
Some patients feel immediate relief with the initial one or two sessions and many feel better after the first three to four treatments.