Menopause leads to decreased blood flow to the vagina (and entire pelvis) which causes skin to become thin, dry, less elastic and it can actually contract and cause narrowing of the opening and entire vagina. The Mona Lisa works by causing thermal damage under the skin that activates fibroblasts to create new collagen and elastin. This allows the skin to become thicker, pliable and to lubricate better. I have patients use Intrarosa or a vaginal estrogen to augment and maintain the effects of the Mona Lisa. In your case, you may also have to use vaginal dilators. However, I would recommend using the vaginal estrogen or Intrarosa and/or Mona Lisa first to prevent pain or bleeding you may have using dilators with the atrophy you have now.
What I see looks like swelling and erythema (redness) of the hymenal tag. This can occur with friction from sex, masturbation, wiping, or scratching. It is more likely to happen in atrophic tissue because the skin is very thin and not as elastic because it is missing collagen and elastin. This kind of irritation can also be seen with exposure to color or scented toilet tissue,bubble bath (other scented bath products), feminine hygiene products, and some lubricants, particularly the warming kinds. I have also seen this with cutaneous yeast infections. I recommend that you see your gynecologist to figure out what it may be. Hope this helped.
