Can Mona Lisa Touch be used on uterine cancer patients who have had pelvic floor radiation?

Can Mona Lisa touch be used on uterine cancer patients who have had 3 pelvic floor radiation and complete hysterectomies? Also do results vary based on the amount of vaginal atrophy? Or length of time one has had vaginal atrophy?

Doctor Answers 7

Can FemiLift or Mona Lisa Touch be used for vaginal atrophy & stenosis caused by external beam radiation for cancer?


I also treat vaginal atrophic changes successfully with FemiLift (Mona Lisa is same technology) pixillated fractional CO2 laser.  As Dr. Pelosi has said, the only limitation is the ability to insert the wand. Results may be less optimal than for non-radiation-induced atrophic stenosis (tightening,) but this therapy really is all you have. Both ThemiVa and FemiLift/MonaLisa theoretically will help you (the FemiLift "wand" is more vagina-friendly.). Unfortunately, there are no side-by-side comparisons of the 2 different wavelength modalities.

My advice? See a local practitioner (preferably a Gyn, who has more knowledge of the disease process that you were treated for...) The web reference below gives you good general info on pixillated CO2 laser therapy.

Best wished for a continued, quality, cancer-free life!

Michael P Goodman

Vaginal resurfacing after radiation

Thank you for your question. I agree with the other doctors in the use of lasers after radiation and is a wonderful technology. However, as Dr Pelosi mentioned, the caliber of the vaginal canal may limit to ability to fit the laser probe comfortably. For this very reason, I use Thermiva radio frequency energy for vaginal rejuvenation in these patients because the wand is smaller than my finger and can be performed with lubricant. CO2 laser has to be used dry because any moisture absorbs the energy and diminishes the effectiveness of the therapy. I use the Thermiva in my patients who cannot tolerate a pelvic exam, or small speculum because of pain attributed to severe atrophy or stenosis(narrowing) of the vaginal canal. Before these technologies were available to me, patients unable to tolerate even an exam would require either painful gradual dilitation at home or required dilitation under anesthesia. With the smaller wand of the Thermiva probe we have successfully treated even the worst cases of vaginal stenosis.

Peter Castillo, MD, FACOG
Bay Area Urogynecologist
5.0 out of 5 stars 10 reviews

CO2 laser for vaginal atrophy

Yes, you may undergo laser vaginal ablation to treat your atrophic vaginal changes. I have experience with FemiLift and see it as a great option for women who've had pelvic irradiation. It also works well for women who develop atrophic changes following menopause.
There is a thin hand piece for the FemiLift laser that makes these treatments possible in women with severe changes.
See link below for more information on FemiLift.
Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 21 reviews

After Radiation, the Results of MonaLisa Touch May Not Be as Good

Your question is an important one. Currently a history of radiation to the vaginal, colon or rectal tissue is listed as a contraindication to Mona Lisa Touch therapy, meaning that it would not be recommended. It is not a safety issue, but an efficacy issue. This contraindication is made because radiation causes permanent changes in the tissues that may prevent the ML laser from being able to be fully effective. Of course there is a wide range in the tissue changes that may be produced by prior radiation treatments because of differences in patients and differences in radiation doses. If your pelvic exam does not demonstrate severe radiation changes, then ML laser therapy could be done, but you should be aware that your response may not be as remarkable as in a post-menopausal woman that has not had radiation.

Mona Lisa and FemiLift for vaginal atrophy from radiation therapy?

Vaginal atrophy after radiation therapy can be treated with laser resurfacing with either Mona Lisa or FemiLift. The challenge is having enough room to insert the probe because radiation therapy also frequently creates scarring, narrowing and shortening of the vagina (vaginal stenosis). Sometimes this requires vaginal dilatation under anesthesia prior to the laser procedure. In less severe cases, a standard vaginal dilator regimen at home is sufficient preparation. Femi Lift has recently introduced a new slim probe for the narrow vagina and is ideal in this setting, eliminating the need for aggressive vaginal dilatation. I'm a consultant for their R&D team and have had the FemiLift Slim available to my patients since late last year.

MonaLisaTouch after pelvic irradiation (hysterectomy)

This treatment is superficial and might be the only one for shortness, dryness without estrogen available, narrowness. This wasn't studied, but the tissue of the vagina should still be able to respond somewhat. I think this would be a wonderful solution if it works in you.  What else is there? Good luck.

Mona Lisa Touch and history of radiation

One of the contraindications for Mona Lisa Touch is previous radiation to the pelvic tissues. The light therapy triggers tissues to regenerate collagen and elastin, but radiated tissue likely will not respond appropriately to the treatment. Hysterectomy alone is not a containdication. Response to the treatment varies and severe atrophic tissue will improve. My patients tend to find noticeable improvement after the second treatment, even if starting at a severe level of dryness. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.