Christopher Fontenot, MD, FACS

What you are describing are two of the classic Genitourinary Symptoms of Menopause: burning and painful intercourse. There are two excellent medical journal articles documenting effectiveness of Mona Lisa Touch Laser therapy in breast cancer patients.  Assuming you have no other issues that would preclude Mona Lisa Touch Laser Therapy (there are a few), you sound like an ideal candidate.

It looks like you have a little "laxity" there but not unexpected for your age. To confirm this, you would need an appt. with, preferably, a Urologist or Gynecologist specializing in female pelvic medicine. Be careful with treatments to correct a "loose" vagina. This often involves a prolapse repair with trimming of vaginal mucosa, with the risk of the vaginal canal becoming too tight, which can make intercourse painful. Mona Lisa Touch may improve the laxity or looseness to a small extent, but laxity is not what the Laser is for. If you are experiencing genitourinary symptoms of menopause, MLT may be appropriate for you.

Hot flashes during peri or post menopause is due to decrease in estrogen levels circulating in your blood. Mona Lisa Touch will not affect this and you are better served seeing your gynecologist for treatment options.

Mona Lisa Touch may help your getting up at night to urinate (known as nocturia). The first thing you should do is complete a "3-Day Voiding Diary"(see link). You should review it with your Urologist or Gynecologist, and try to determine the exact cause of your nocturia. If you and he/she feel the nocturia is perhaps due to vaginal atrophy (which also implies urethral atrophy as well) then MLT may help. Keep in mind however that no scientific study has been done to look at the effectiveness of MLT in treating nocturia. Some patients have reported improvement after MLT treatment however.

There is no data suggesting that Mona Lisa Touch is more painful in older women. However, some women may just experience more pain than others, especially with the external treatment. And yes it's true that on internal treatments, more energy is delivered during the second and third treatments(the number of pulses in one spot with each firing of the laser, known as the "Smart Stack). We use a propietrary mixture of benzocaine, tetracaine, and lidocaine cream, and have had minimal to zero discomfort expressed by any patient. If you are experiencing pain, perhaps your treating physician can dial back the intensity a bit. Also, if you are experiencing pain from just insertion of the probe, you can also ask your treating physician if he/she has a narrow probe available.

There is no restriction on phyical activities, other than no intercourse for 24-48 hours for the internal treatment, and 7 days for the external treatment. If you have had internal treatment you should be able to return to work immediately. The same goes for the exteral treatment but you will need to wear a loose fitting cotton undergarment, and loose fitting pants(skirt is no problem), for a few days. Also, application of topical anesthetic cream (we use 5% lidocaime cream) to external genitalia may be necessary for 2-3 days.