A Promising New Treatment for Vaginal Dryness

There may be a Santa Claus after all, Virginia.

Of all the menopausal afflictions, vaginal dryness (or genitourinary syndrome of menopause—GSM—in medicalese) is the most pervasive. Virtually all of us will experience GSM to one degree or another, either due to menopause, hysterectomy, breast cancer, or some other hormone-disrupting event. Some of us will suffer from GSM to such an extent that sex or even a gynecological exam is impossible.

Yes, lubes and creams help. Estrogen replacement helps a lot, but not all women can or want to use hormones (especially if they’re breast cancer survivors, although localized estrogen has been confirmed safe). And there’s Osphena, a new nonhormonal drug that has proven effective. Still, nothing beats that firm, moist tissue we took for granted at 30.

Enter the MonaLisa Touch. With a name like that, you might hazard a guess that it was developed in Italy, and you’d be right. (I’ll never view that enigmatic smile in the same way again.) The procedure has been available in Europe and South America for a while and was recently approved for use in the US by the Food and Drug Administration.

The MonaLisa Touch is the same type of laser abrasion used to rejuvenate facial skin but repurposed for vaginal tissue. (This should not be equated with cosmetic surgery, however.) It’s a laser treatment that creates small lesions and removes a surface layer of dry vaginal cells. This causes the vagina to make collagen and stimulates the mucus membranes. A new, moist, healthy layer of tissue then develops.

Voilá!  A 30-year-old vagina.

Wait a minute, I can hear you say: What about side effects? What about risks? Is this procedure appropriate for everyone?

Well, that’s the thing. The procedure appears to be safe and appropriate for women suffering from GSM, painful sex, mild urinary incontinence, and/or frequent urinary tract infections. Pain and side effects are slight—maybe one or two days of redness or soreness. It’s an outpatient procedure done with no or very little anesthetic.  Results have been promising with 85 to 90 percent of women experiencing relief, sometimes almost immediately and sometimes significantly. “This is as close to the best result a medical treatment can achieve,” says Dr. Cynthia Krause, ob/gyn and assistant professor at the Icahn School of Medicine in New York City.

The procedure is straightforward, involving three laser treatments performed at six-week intervals. While many women experience relief quickly, the full effect may take up to six weeks after the final treatment. Laser treatment of vulvar and external vaginal tissue may also help with urinary incontinence and UTIs. Following that, an annual “touchup” may be required.

So, what’s the catch?

Well, for one thing, the procedure is new. While short-term studies are very positive, long-term data on side-effects or efficacy simply isn’t available. For another, it’s the cash. Since the procedure is new, most insurance companies won’t cover it, although that may change as the treatment becomes more mainstream. Cost varies depending on the region, but ranges from around $1500 to almost $2000 for the three required treatments.

Still, many women are thrilled with the chance to enjoy pain-free sex with their honey again, not to mention the freedom from a painful, burning, itching bottom. Like any treatment, however, there are no guarantees. Not every woman experiences the same result.

Still, for many women who suffer from the sexual difficulties and pain of GSM, the MonaLisa Touch is definitely worth looking into.