There is a new treatment for painful intercourse in menopause that doesn’t involve prescription medication. The MonaLisa Touch laser has been used in Europe and Australia for years with over 10,000 women treated so far. It was FDA approved for use in this country in 2014. It uses a fractional carbon dioxide laser, the same laser that has been used for many years in the treatment of dermatologic conditions and anti-aging treatments of the face, neck and chest.
In menopause, lack of estrogen leads to loss of elasticity of the vaginal walls and less blood flow to those tissues. The change in blood flow and hormonal picture leads to dryness, narrowing and rigidity of the vagina, changes in the pH and vaginal discharge, and can even increase the risk of urinary tract infections.
Treatment options have been limited for decades and have included over the counter lubricants and vaginal moisturizers, or prescription estrogen vaginal creams, tablets and rings. A relative newcomer in the treatment of painful intercourse in menopause is the prescription daily pill called Osphena. Many women find these treatments quite helpful. Many women treated for breast cancer or women with a history of a blood clot like stroke or dvt may not be able to use those prescriptions, however.
The MonaLisa laser works by delivering pulses of laser energy to the fragile vaginal tissue. This causes a cascade of tissue-injury responses that allow those treated areas to be filled in with fibroblasts, collagen, tissue-building matrix and capillary blood vessels. The increase in blood flow and connective tissue then improve vaginal elasticity, pH, and lubrication. Some women also report improvement in mild prolapse and urinary incontinence, but those improvements in response to the MonaLisa are not yet studied.
Treatment involves 3 treatments 6 weeks apart and then once yearly after that. Each session lasts approximately 5 minutes and is virtually painless. Because it is a newer therapy, insurance does not yet cover the cost of the treatments.
The MonaLisa laser is a wonderful tool to treat atrophy and painful intercourse in menopause. It’s been an extremely effective treatment option for women that haven’t responded to vaginal or oral prescriptions and for women who cannot or will not use hormonal therapies.
Talk to your health care provider about whether or not the MonaLisa laser is an option for you. Each method has pros and cons and a thorough discussion is needed to make the best plan of care for you!