At age 69, I am having terrible tearing and rubbing with intercourse. Had treatment, just a bad as before. Is this normal?

At age 69, I am having terrible tearing and rubbing with intercourse. So I went for MLT. I just had first treatment and it has been l l/2 weeks. Been keeping it moist with vaseline. Well, we had sex and it was just as bad as before. Now I'm rubbed raw again. I also have Lichen and was treated for that also. So my question is..........is this normal? How do I heal inside again. We have (had) a very active sex life and this is very depressing....IT'S TERRIBLE TO AGE THIS WAY.

Doctor Answers 5

Bad as before?

You must "hang in there." This is a 3 time fractional laser treatment over 4 mos. and it may take the skin longer than three treatments if you are older with lichen sclerosis. It is effective but the skin is a limiting factor, especially if no history of vaginal deliveries for example. You should use estrogen cream to the skin 2-3 times a day in small amounts during the healing phase. The inside will not need it. The LS is treated as you probably know with clobetasol which will not speed up the healing at all, may slow it further. The second and third vaginal treatments will be at a higher energy. Good luck.

Don't give up!

Please, please do not give up. There is a reason that 3 treatments are required for vaginal atrophy and 5 external treatments for lichen sclerosis. One treatment will just start the healing/reparative process by first resurfacing the vagina and starting to activate the dormant reparative proteins to begin creating new collagen,elastin, and blood flow in the vagina and vulva. For lichen sclerosis the clinical studies are still ongoing, but we do know that 5 external treatments are required to repair the vulva. I have treated several patients with lichen sclerosis with great results. I told them at the start to be patient and give each treatment it's due diligence and they would see results, and they have. You may benefit by continuing your lichen prescription therapy during this course of treatment (but nothing in the vagina for a week before each treatment) until you complete your MonaLisa treatments for it can be synergistic. 

Therapy not complete.

The MonaLisa vaginal therapy will require 3 treatments, while the external   Lichen sclorosus may take up to 5-6.

For most women who have exhausted all medical options the Laser treatment gives the best and only option available. So please be patient and work with the physician who is treating you.

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You are not normal and you can't expect normal results to happen quickly

You have multiple issues contributing to painful sex. It takes time for these to recover. The usual recommendation that sex can be resumed comfortable 3 days after MonaLisa or FemiLift is for women with atrophy only, not a combo of atrophy and LS. You need longer healing time and to work with a clinician who will offer you ongoing care especially since women with LS have a higher risk of skin cancer of the vulva. I would assume that your LS was diagnosed on the basis of skin biopsy. If not, you need to get one done immediately and seek out a true gynecologic expert. Sometimes multimodal treatment is required.

Please be patient

Hi Bullet!  Remember that a full course of MonaLisa Touch includes 3 treatments.  Please be patient.  And, as you know personally, having lichen sclerosis makes your skin very fragile (more fragile than women without the condition) and may make the healing process take a bit longer.  My patients have noticed slow and steady improvement after each of the three MonaLisa treatments, but I encourage them to receive all three treatments before making a judgment on how effective it's been.  Please be patient and wait until 6 weeks after your third treatment to enjoy the full benefits.  In addition, talk to your doctor and additional treatments on the outside of your vagina (vulva) may be necessary as well.  Good luck and I hope you have the same success that I'm seeing with my patients!


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.