What is the MonaLisa Touch treatment and how does it work?

An article about the MonaLisa Touch and what it's supposed to do and how it works?

Doctor Answers 17

MonaLisa Touch is a treatment for Vaginal Atrophy after menopause, cancer treatment, or oophorectomy (removal of ovaries)

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As already mentioned, The MonaLisa Touch is a fractional CO2 laser that is specifically designed to treat vaginal tissue.
The MonaLisa Touch was recently approved by the FDA (12/2014) for the treatment of the symptoms associated with Vaginal Atrophy such as:
  • Vaginal itching
  • Vaginal dryness
  • Pain during intercourse
  • Vaginal laxity
Additionally, patients have experienced relief to secondary symptoms such as urinary incontinence.

Because of the last item on the vaginal atrophy list, many people have mistaken this treatment as a vaginal tightening treatment. Although patients will notice a tightening due to the changes in the thickness and texture of their vaginal tissue, the goal of this treatment is not to tighten. It is to change the underlying health of the tissue so that women in menopause can "feel normal' again.

Although it is a fractional CO2 laser treatment that is fired inside of the vagina, there is no pain associated with the treatment itself. The only discomfort that my patients encounter is on their initial treatment when first inserting the laser handpiece into the vagina. This discomfort is due to the patient's vaginal atrophy symptoms and they have indicated that it is less discomfort than a speculum insertion. Most patients describe the actual laser firing as a slight vibration.

A typical MonaLisa treatment takes 3 minutes or less of actual laser-treatment time. As a patient, your visit would go something like:
  • After check-in, your vital signs will be taken.
  • You will be brought into the procedure room, where you will be given some privacy so that you can disrobe and put on a gown.
  • You will then be placed on an exam table and your feet will be placed in stirrups in the same manner as a vaginal exam / pap.
  • The physician place a sterile "insertion ring" into your vaginal opening (this is a circular device that allows the laser handpiece to be inserted and moved without rubbing against your labia).
  • After complete insertion, the laser will be fired, moved, fired again, etc. until the entire inside of the vagina has been treated.
  • After the treatment, you will need to refrain from putting anything in your vagina for a few days.
  • Some patients have indicated that their first urination after the treatment feels different (not painful). They have described it as "noticing" or "feeling" their urine flow in a different way.
Most patients experience symptom relief within the first week. All of our patients have expressed significant improvement within 2 weeks.

The current recommendation is that patients should receive a maintenance treatment on a yearly basis to prevent vaginal atrophy symptoms from reoccurring.

Every patient we have treated has been ecstatic with their results.

I cannot stress enough how life-changing this treatment has been for our patients. These women have suffered for years. Some have not been able to be intimate with their partners for years and now can be again.

Vaginal atrophy affects millions of post-menopausal women and this is the first real medical treatment that they have that is non-hormonal and provides real long-term relief.

Additionally, many breast cancer survivors suffer from this condition as well. Due to their medical history of cancer, they cannot use hormone therapy for relief.  This is their only real treatment at the current time.

Effectiveness of Mona Lisa Touch

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Was the article you saw a scientific article or a marketing article? Mona Lisa Touch (tm) is a laser system made by DEKA Laser Co. in Germany.  It is used in Europe and South America, and being introduced into America.  It is a "system" using laser energy appplied with an intra-vaginal wand to tighten the skin of the vagina.

Unfortunately, it does nothing to tighten or strengthen the muscles.  Also, there are no long-term studies regarding effectiveness.  It is "non-invasive" but untried and certainly won't do the job long-term and may have to be repeated frequently.  In that case, there is no data as to whether this would produce any permanent harm to the vaginal walls.  It is in no way the same as "Laser Vaginoplasty or the use of the Laser as a tool for a surgical tightening procedure.  Totally different and not as effective...

To get scientific data, Google "Mona Lisa Touch, Pubmed" and you will see if there is any scientific merit in the procedure.  "Pubmed" tracks all articles in the peer-reviewed scientific literature.

Regards,

Michael P Goodman MD

What is The Mona Lisa Touch?

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Let me start by stating what it is not:  Mona Lisa Touch is not a "vaginal
rejuvenation" procedure. To be more accurate, the Mona Lisa Touch is a vaginal revitalization procedure to bring back function to women who suffer from GSM (Genitourinary Syndrome of Menopause). Some lasers promote tightening, thus indicating a cosmetic purpose. Mona Lisa Touch should be viewed as a medical treatment to counter vaginal dryness and the uncomfortable symptoms associated with menopause. This simple in-office procedure will stimulate collagen production and in turn improve the blood supply and moisture levels to the vaginal tissues. Mona Lisa Touch is about function and allows menopausal women to reclaim a higher quality of life. 

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What is MLT and how does it work?

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The MonaLisa Touch is a medical laser that delivers controlled energy to the vaginal tissue. The treatment revitalizes the cells in the vaginal tissue so that they make more collagen, an essential ingredient in vaginal cell health. The MonaLisa Touch procedure is used for the treatment of vaginal atrophy and can help women recover from genital atrophy to enjoy complete relief from the symptoms they experience every day. These symptoms can include vaginal dryness, burning, discomfort or painful intercourse, vaginal discharge, genital itching, burning or urgency with urination, increased amounts of urinary tract infections, urinary incontinence, light bleeding after intercourse, overall decreased lubrication during sexual activity and/or shortening and tightening of the vaginal canal. 

MonaLisa Touch works by promoting the recovery of the genital mucosa balance in a safe, painless way through methods similar to those used to treat aging facial skin. The MLT Laser's effect on vaginal tissue stimulates the production of collagen, improves functionality of the treated area and restores proper flood flow reversing the effects of vaginal atrophy. A two part pulse targets surface (epithelial) tissue and deep (lamina propria) tissue to promote vaginal mucosal revitalization. Fractioned beams of light will penetrate small areas of tissue creating small wounds in the epithelial layer of the vaginal mucosa. This triggers fibroblast activity which will stimulate the new collagen production. 

Treatment is virtually painless and the process only takes 3 treatments, each lasting just seconds. A significant amount of improvement is noted even after the initial treatment, however 3-4 treatments are recommended. As with other laser therapy, annual maintenance is recommended to ensure longevity of your results. 

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What is the MonaLisa Touch treatment and how does it work?

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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.

What is MonaLisa Touch?

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MonaLisa Touch is an FDA approved procedure for the treatment of Vulvo-Vaginal Atrophy (VVA). The MonaLisa Touch procedure uses a Laser to stimulate the mucosa, which regenerates and “rejuvenates” the vaginal tissue to a healthy state. The procedure is painless and takes only a few minutes with no downtime. Treated patients can resume sexual activity after 48 hours. Most patients report a noticeable increase in lubrication and mucosal elasticity after the first treatment. For optimal results a course of 3 sessions is recommended spaced 6 weeks apart, with maintenance treatments once every year or as needed. Though there can be some tightening of the vaginal canal, this is not the primary objective of MonaLisa. If you are looking for vaginal tightening I would recommend looking into the IntimaLase procedure. IntimaLase is also a quick, virtually painless procedure and has been shown to tighten the vaginal canal by an average of 17%. Hope this helps.

What is the Mona Lisa Touch

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the Mona Lisa Touch is a fractional laser treatment that is used to treat vaginal atrophy.  As a woman's estrogen level falls, tissues that are sensitive to estrogen will dry  and change - vagina, bladder, and vulva are extremely vulnerable to this,  As a vagina atrophies, it can become dry, itchy, bleed easily making intercourse painful and affecting the bladder causing dribbling, frequency and incontinence.  The Mona Lisa Laser treatment results in an increase in blood flow, thickening of the tissue and restoring tissue strength.  It is a local treatment only and does not interfere with any other organs, systems or diseases in the body.  There are 3 treatments, 6 weeks apart, and works exceptionally well to restore vaginal health.

What is Mona Lisa Touch Laser Therapy and how dose it work.

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Mona Lisa Touch Laser Therapy is a painless, office-based method through which a woman's vaginal tissue can be treated for dryness and irritation. Similar to the CO2 laser used for facial skin, the Mona LIsa Touch Laser gently removes and replenishes the vaginal canal so that new, well-nourished, moist tissue can grow. The treated women will self-lubricate during sexual stimulation, allowing for  more comfortable, responsive, and enjoyable intercourse. For women with dry irritated vaginal tissue who are not sexually active, it can provide relief on a daily basis well after the treatments are completed. 

Improve quality of life, sexual function, and vaginal changes due to decreased estrogen with the MonaLisa Touch.

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The MonaLisa Touch is a unique fractional CO2 laser therapy used to treat vaginal and vulvar skin disorders.  Symptoms of what was called vulvovaginal atrophy but is now called genitourinary syndrome of menopause result from decreased estrogenization of vaginal tissue:

  • Vaginal Dryness, irritation, soreness, burning
  • Painful Sex
  • Discharge
  • Frequent Urination
  • Post menopausal chronic vaginal infections
  • Post menopausal chronic urinary tract infections

While these changes can occur ANY TIME in a woman’s life, they occur in as many as 50% of postmenopausal women in the United States. In addition, women who have had their ovaries removed (oophorectomy), and over 2.8 million breast cancer survivors in the United States may also suffer from these symptoms.  Patients who are not candidates for or wish to avoid traditional systemic or topical hormone therapy now have another option. 

Patients with external skin atrophy and vulvar lichen sclerosis also benefit from treatment with the MonaLisa Touch.

Many patients ask if the MonaLisa Touch will tighten a “loose vagina” caused by giving birth or tissue relaxation due to ageing.  The procedure may improve mucosal tone loss by increasing tissue elasticity and patients may experience a tightening because of changes in thickness and texture of the vaginal tissue. 

This 5 minute procedure takes place in our office and is similar to an annual vaginal exam.  It is virtually painless.  The laser is inserted into the vagina and delivers laser energy “pulses”, which immediately stimulate ingrowth of new vaginal tissue.  Because the procedure stimulates the body’s own natural healing response, it lacks the risks and side effects associated with traditional medical therapy.  To obtain optimal results, we recommend 3 treatments spaced 6 weeks apart; however, we individualize treatment recommendations and some patients may benefit from additional therapy. 

Many of our patients report that they experience relief right away, especially less dryness, better lubrication, and relief from painful intercourse.  Virtually all patients have experienced relief by the second treatment.  

Lewis Wyatt Jr., MD
Beverly Hills OB-GYN

What is the MonaLisa Touch treatment and how does it work?

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THE MONALISA TOUCH procedure is a game-­‐changing, (and for many women, Life-­‐changing), non-­‐estrogen, clinically-­‐proven, revolutionary therapeutic laser that that helps millions of women who are suffering with problems of vaginal health. It promotes the return vaginal and vulva health and wellness to its former state.

WHAT IS THE ISSUE?

The issue is the changes that occur in the vaginal tissues due to the decrease in the Estrogen levels that is commonly seen in post-menopausal women, breast cancer survivors and women who have had a hysterectomy.

Vaginal changes occur due to decreased estrogen levels:

  • Vaginal atrophy
  • Vaginal dryness, itching, burning
  • Decrease in vaginal secretions and lubrication
  • Decrease vascularity
  • Loss of elasticity
  • Pain and discomfort during intercourse
  • Changes in the vaginal pH which increases the chance of vaginal infections
  • Awareness of daily Vaginal discomfort

Existing treatments for post-­‐menopausal vaginal health issues involve Estrogen pills, gels, creams, vaginal rings, Ospemifene… but they can be messy, expensive, and time consuming to use. These treatments can be time intensive, messy, expensive, or contraindicated for health reasons, and they can have numerous side-­‐effect. And all people can’t or don’t want to use estrogen.

HOW DOES IT WORK?

The system is designed to REVITALIZE and RESTORE… to stimulate and promote the REGENERATION and REJUVENATION of the collagen fibers and the restoration of hydration and elasticity within the vaginal mucosa. The laser is able to release energy through a special pulse, and the laser energy heat PAINLESSLY penetrates to a depth that stimulates the synthesis of new collagen, glycogen, and elastin, thus increasing hydration and moisture that brings the tissue back to a healthy, youthful, functional state.

The MONALISA TOUGH treatment is particularly well suited for patients who cannot, or prefer not to receive estrogen therapy.

WHAT STUDIES HAVE BEEN DONE TO SHOW IT WORKS?

The MonaLisa Touch has been clinically proven to bring highly statistically significant improvement in symptoms and long-­‐lasting relief after the first treatment. The MonaLisa Touch has been used to treat thousands of women since 2008, where it was first introduced in Italy. The MonaLisa Touch treatment has been used WORLDWIDE under a variety of protocols with excellent results. It was FDA approved for use in the United States in October 2014. The multicenter trial Clinical trial were done in the United States by Dr. Mickey Karram, a Urogynecologist and the director of the Fellowship program on Female Pelvic Medicine and Reconstructive Surgery at the Christ Hospital in Cincinnati, OH and Dr. Eric Sokol, Associate Professor of OB/GYN at the Stanford University Medical Center in California.

DOES IT HURT?

The MonaLisa Touch is a minimally-­‐invasive, painless procedure, performed in an office setting and requires NO ANESTHESIA. The laser energy itself is painless. Some patients report mild discomfort with the laser tip insertion only during the first treatment due to vaginal dryness. Most women describe the laser treatment as “feeling vibrations in the vagina.”

HOW LONG DOES IT TAKE?

Each treatment takes less than 5 minutes. You can be in and out of the office in 30 minutes.

HOW MANY TREATMENTS ARE REQUIRED?

To obtain OPTIMAL results, THREE treatments are needed, each 6 weeks apart. The reason we do all three treatments is because that is the prescription; that is how it has been studied, and has been shown to give the long term benefits.

WHEN WILL I SEE RESULTS?

70 – 90% see overwhelmingly positive and immediate results after the first treatment, with the continuation of improvement with each subsequent treatment.

HOW LONG DOES IT LAST?

1 year or more, with a once-­‐a-­‐year treatment for maintenance.

WHAT ARE THE LIMITATIONS AFTER THE PROCEDURE IS DONE?

No intercourse for 2 days.

FOR WHICH PATIENT IS THE TREATMENT APPROPRIATE?

Any woman having symptoms of genital-­‐vaginal atrophy of menopause, either natural or induced by surgery (hysterectomy) or medications (given after breast cancer.) Once vaginal health and the proper pH is restored, the pre‐menopausal bacterial environment will return, so that you will no longer be prone to vaginal discharge, infections, itching, burning, and urinary symptom.




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.