MonaLisa Touch: Who Is A Candidate?

What are the symptoms that I should be aware of and when should I seek treatment?

Doctor Answers 15

MonaLisa Touch: Who Is A Candidate?

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Mona Lisa Touch and Femi Lift by Alma are both fractional CO2 laser devices. They are equally effective and produce excellent results. We have Femi Lift in our practice. ThermiVA is a radio frequency based device that works through direct bulk heating. ThermiVa has been supported by claims that it increases lubrication and improves vaginal function. In that ThermiVa is not FDA approved for intra-vaginal use, and that these claims are not supported by any valid, peer reviewed studies that I can find, it is unlikely that ThermiVa will help with any vaginal issues in a lasting way.. This technology is not able to raise tissue temperatures sufficiently to promote new collagen growth (Neocollagenesis), which is necessary for any lasting results. It has been shown that Neocollagenesis occurs ONLY when the tissues are heated to 60-70C. ThermiVa absolutely does not heat tissues to 60-70C, but only achieves perhaps 45-55 degrees Celsius. By heating the vaginal lining tissues, ThermiVa causes swelling, or edema. There is no scientific basis that supports the notion of ThermiVa producing long lasting results. Furthermore, as we all learned in 2nd year medical school pathology class, chronic inflammation and edema leads to FIBROSIS (a pathologic process). Fibrosis is a disorderly process of SCAR FORMATION, as opposed to the functionally regenerative process of Neocollagenesis. Think about nasty ugly scars on the skin that occur due to injury. That is the process of scar formation. Fractional laser devices, such as Femi Lift by Alma lasers, actually have been shown through rigorous scientific study, to promote Neocollagenesis by heating the vaginal lining tissues to 60-70 degrees Celsius. Furthermore, Femi Lift also causes fractional ablation of the vaginal lining, resulting in regrowth of a thicker and more youthful vaginal lining. In my practice we have treated dozens of patients with Femi Lift and I have nor seen a single treatment failure. Furthermore, most, if not all of my stress urinary incontinence patients (mild to moderate severity) have completely resolved their SUI.

Non-surgical Vaginal Tightening with Mona Lisa Touch

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MonaLisa Touch by Cynosure is one of three companies available in the US that use lasers inside the vagina to improve tissue tone and moisture. Lasers can work for anyone who is perimenopausal or menopausal internally to improve vaginal moisture. This is what the Mona Lisa Touch is marketed for.  Most doctors prescribe estrogen cream or pills to achieve the same goal of increased moisture at a much cheaper cost. MonaLisa Touch does not have a US indication for vaginal tightening although they do so overseas and market it aggressively. Cynosure wants to market for vaginal tightening but are not allowed to say so just yet so they get around this by marketing treatments for dry vaginas. The treatments are done with machinery that are the exactly the same as ones used for faces. However, special designed vaginal probes with mirrors and shiny surfaces are used to bend light to treat the vaginal walls by placing hundreds/thousands of micro holes that intend to stimulate collagen productions and increased blood flow . Results are reported good by the companies in terms of improvement of vaginal dryness. It does not do significant tightening of the vagina that replaces surgery as far as I am able to determine. I have spoken with the most prolific users of these devices who speak highly of its use for those who do not want surgery for vaginal tightening in Europe and South America.  They do work as advertised and are safe.  The costs can be high.  

As I stated in an earlier post, I find the use of radio frequency to be superior to any of the vaginal lasers because it can treat the external labia and tighten it and reduce the "Camel Toes" that the lasers really cannot do. I find the radio frequency treatments inside the vagina to be much superior also in terms of tightening effects, increased lubrication and moisture, and even reduction in leaky bladders and overactive bladders. Surprisingly radio frequency effects can also help with orgasmic dysfunction. Those who take a long time to achieve orgasms or are anorgasmic have been helped with radio frequency devices.  It is known that radio waves have a tissue healing and regenerative effect that stimulates your own cells to produce growth factors, collagen, and improved blood flow to local areas. In my practice I have been amazed at the results obtained using radio frequency in an extremely safe, comfortable manner with zero downtime.  The effects lasts an average of 9-12 months.  For full disclosure, I am biased because I helped invent and develop the radio frequency device and have almost ten years of experience working with the technology. Radio frequency devices for vaginal use will enter the US and European markets in May, 2015.

Hope this helps.

Warm regards,

Red Alinsod, MD

Red Alinsod, MD
Laguna Beach OB-GYN
5.0 out of 5 stars 28 reviews

Who is the best candidate for the Mona Lisa Procedure?

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In my medical practice, the ideal candidate for the Mona Lisa, or any of the other vaginal radio frequency heat or laser treatments, is a woman experiencing  symptoms related to aging, menopause or childbirth. Symptoms include vaginal dryness, painful intercourse, urinary frequency, urgency or stress urinary icontinence. Women experiencing difficulty reaching orgasm and/or diminished vaginal sensation also benefit from these procedures in my experience. 

Symptoms and Candidacy for CO2 laser treatment

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The MonaLisa Touch (A fractionated CO2 laser) is designed to treat the vaginal and vulvar tissues that are effected by estrogen deficiency, either from spontaneous menopause, surgical menopause, or postnatally. Lack of estrogen often results in thinning of the vaginal lining (mucosa) and lack of moisture and lubrication, both of which can result in painful intercourse, burning, and itching in vaginal and vulvar skin. The loss of collagen and support in the vaginal mucosa/bladder/urethra can also increase urinary discomfort, pain, frequent urinary tract infections, and mild incontinence. Treatment with CO2 lasers stimulates the production of collagen in the vaginal mucosa and vulva, as well as increases blood flow, and lubrication. This treatment is offered to perimenopausal and postmenopausal women who have these issues and would like an effective and safe alternative to estrogen therapy and/or surgery. Patients who also experience these symptoms but are not yet menopausal may also benefit from treatment. 

What symptoms does MonaLisa Touch help?

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MonaLisa Touch can help relieve many of the  symptoms women experience from the low estrogen effects  of natural, surgical or chemo induced menopause. Symptoms like  vaginal dryness, pain and burning with penetrative sex,  urinary urgency and frequency  well as  recurrent bladder and vaginal infections. It is also being used to treat a vulvar condition called Lichen Sclerosis.

Karin DeNevi, MD
Danville OB-GYN

Will you benefit from Mona Lisa Touch Laser Therapy

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Women who have the best results with Mona Lisa Touch Laser Therapy are estrogen depleted, sexually active women who do not want to use lubricants and estrogen products, or in whom lubricants don't work and estrogen is not safe. Examples of women in this demographic include women of all ages who have survived breast cancer, women who are menopausal, and women with lichen sclerosis. It really works in young women who have been treated for breast cancer with surgery and chemotherapy who are very concerned about using any estrogen products. Young women who have premature menopause do very well also. Older women who have been menopausal for years can do very well with Mona Lisa Touch Laser Therapy. And, for lichen sclerosis, it can be a lifesaver. 

Mona Lisa Touch to help intimacy issues

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Mona Lisa Touch is best suited to those struggling with vaginal dryness, urinary incontinence, and painful sexual intercourse related to peri and post menopausal changes from estrogen levels decreasing.  Vaginal tightening may also be seen in some women.  Also, women undergoing hormonal treatment of breast cancer are great candidates as well.  These ladies are pushed into medical menopause with hormone blockers.  Some women being treated in their early twenties for their breast cancer can have post menopausal symptoms very early in their treatment.  One of my young patients described having sex like her husband was wearing a sand paper condom during intercourse.  This can be improved.  As a doctor who deals with breast cancer daily and a CO2 laser expert, my best advice is to get treatment early to maintain rather than wait and try the uphill battle to regain.

Lisa M. Hunsicker, MD
Denver Plastic Surgeon
4.8 out of 5 stars 16 reviews

Non Hormone treatment for atrophy and sexual function

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There are many groups who benefit from MonaLisa Touch (MLT) therapy.  The top reasons that we treat patients are:

1) Vaginal atrophy in menopause.  We use the MLT laser to relieve symptoms of itching, burning and pain with intercourse.  It normalizes the tissues, pH and bacteria in the vagina without the use of hormones.  This is especially good for women who can not use hormones (breast cancer, uterine cancer, blood clots) and those who have not had success with hormone.  Some women just don't tolerate the pills or creams, and find this a wonderful alternative.

2) Urinary symptoms. Especially in menopause (but even before) we see and increase in urgency and frequency of urination and can also see an increase in stress incontinence (losing urine with cough, sneeze, exercise).  MLT laser can help with all of these symptoms, as long as there is no anatomic disorder that needs to be fixed.

3) Lichen Sclerosis.  Women with lichen sclerosis can see an improvement with external treatment with MLT, which may allow them to significantly reduce their topical steroid use.


I hope this helps. 

Who is a Candidate for the MonaLisa Touch vaginal laser treatment?

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Candidates for the MonaLisa Touch™ vaginal laser treatment include the following:

  • women who wish to avoid the risks associated with hormone replacement therapy (HRT).
  • GSM or vaginal atrophy, vaginal dryness – usually menopausal
  • dyspareunia (painful intercourse)
  • a history of breast cancer, thrombophlebitis, or other contraindications to estrogen
  • poor responders to estrogen treatment
  • patients with the goal of returning to premenopausal health
  • women who experience medical induced menopause (surgery)

Women don't talk about it!!!

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As a urologist with Subspecialty certification in  female pelvic medicine and reconstructive surgery I have searched for many years for options for women who do not want to take medication for vaginal dryness and painful intercourse. The solution I have found is the Mona Lisa vaginal laser treatment. Finally my patients are enjoying intermacy with there partners. 

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.