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 14

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

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.

Wellington OB/GYN

Effectiveness of Mona Lisa Touch

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.


Michael P Goodman MD

What is The Mona Lisa Touch?

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. 

L. Jennifer Murphy, MD
Valparaiso OB/GYN
5.0 out of 5 stars 5 reviews

What is MLT and how does it work?

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. 


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

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.

Steven M. Gitt, MD, FACS (in memoriam)
Phoenix Plastic Surgeon
4.8 out of 5 stars 36 reviews

What is MonaLisa Touch?

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.

Shelena Lalji, MD
Sugar Land OB/GYN
5.0 out of 5 stars 3 reviews

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

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.


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.


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.


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.


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.”


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


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.


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


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


No intercourse for 2 days.


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.

What, Why, and How

The MonaLisa Touch laser is a painless gentle laser that uses pulses of CO2 laser energy to treat some of the most common side effects of genitourinary syndrome of menopause (GSM) and vulvovaginal atrophy. Many women experience vaginal dryness, vaginal/vulvar itching and burning, painful intercourse, frequent vaginal/urinary tract infections, and mild urinary leakage because of changes that occur with declining estrogen levels. The MonaLisa Touch laser is performed in the office, requires 3 treatments six weeks apart followed by an annual maintenance treatment to maintain results, each treatment takes 5 minutes after a 15-20 minute pre-treatment with an anesthetic cream. A probe is placed in the vagina and the laser pulses are applied to the vaginal walls in 1cm increments.The laser energy promotes collagen formation, new blood vessels and increased blood flow, and more elastin. The results provide healthier vaginal tissue that naturally lubricates better, more elasticity and a tighter vagina (improves comfort and sensation with intercourse), a more balanced pH thus fewer vaginal and urinary tract and vaginal infections, and more support to the urethra thus decreasing or alleviating mild urinary incontinence. An external probe delivers the laser energy to the vulvar tissues thus increasing collagen formation, elasticity, and comfort to the external tissues thus alleviating itching, burning, and cracking/tears that occur with thinning of this tissue. In many cases, patients will begin to notice an improvement almost immediately after the first session. 

Kelley London, MD
Lake Forest OB/GYN
5.0 out of 5 stars 5 reviews

Mona Lisa to improve Vaginal and Pelvic Health

What can a women do if aging and lack of Estrogen is causing problems with Intimacy, bladder infections and urine leaks?

The Genitourinary syndrome of menopause(GMS) is the new terminology used to describe symptoms occurring due to vulvovaginal atrophy caused by low estrogen seen at menopause. This syndrome may also occur after removal of the ovaries or chemotherapy treatments for breast cancer. What we see is the superficial vaginal cell lining is lost and the layers become very fragile. This leads to lack of the natural secretions, folds and elasticity and the vagina has more laxity, shortening and narrowing. These women have symptoms of  vaginal dryness, discharge, itching and Pain or sensitivity with intercourse. The thin vaginal skin tears easier worsened by the lack of  lubrication causing the issues with sexual dissatisfaction. Also, the vaginal canal changes from a acidic to a more alkaline environment, causing the normal good vaginal bacteria to disappear. The "bad " bacteria start to dominate leading to recurrent bladder infections. This often results in overuse of antibiotics by unknowing physicians. 

It is amazing fact that 50 % of postmenopausal in the United States report symptoms of vaginal atrophy affecting there quality of life. These women complain of decrease sexual encounters, sexuality, negative impact on marriage or relationships and self esteem.

As a specialist in treating women with these issues, I have prescribed estrogen based vaginal creams or pills to help overcome the associated symptoms of GMS. The concerns of such therapy include potential side effects, the mess of creams, cost of on going medication needs. Our Lake Norman office is the only and first practice in Charlotte offering a new ground breaking laser technology for women experiencing symptoms of vulvar and vaginal atrophy as another option to chronic prescription medications. The therapy is a new fractional CO2 laser treatment that is done in an office setting. The therapy has been well studied and is tremendously successful at revitalizing vaginal and vulvar skin, thus treating the common symptoms of pain with intercourse, vaginal burning, painful urinating, recurrent bladder infections and incontinence. The laser technology helps restore the normal vaginal layers, folds, secretions and pH.
It is a 5 minute in-office procedure with 3 treatment sessions. A annual "touch up " is recommended to maintain the youthful  vaginal revitalization.
I have been fortunate to treat many women, some of which have been breast cancer survivors on Tamoxifen with this ground breaking laser. These patients have been very satisfied with the improvements in their symptoms . Some  have even recaptured their youth.

Our office is also offering the ThermiVa a Radiofrquency approach for Vaginal restoration. The options of which therapy to choose will depend on the patient's symptoms and anatomy.

John Hettiarachchi, DO, FACS, FPMRS
Charlotte Urologist
5.0 out of 5 stars 26 reviews

Treating Vaginal Dryness and Painful Intercourse with the MonaLisa Touch.

Vaginal dryness, which is one of the most common conditions resulting from menopause and breast cancer survival, can now be treated with the MonaLisa Touch™ fractional C02 vaginal laser. The MonaLisa Touch has been shown to improve vaginal dryness and painful intercourse (dyspareunia).

The treatment itself is much like your annual exam and can be done in a physician’s office without anesthesia. The MonaLisa Touch™ vaginal probe is inserted into the vagina delivering thermal heat to the deep layers of skin of the vaginal wall. This increases blood flow and stimulates collagen growth beginning the process of restoring vaginal health. Patients can return to normal activity following a treatment session.

Noticeable results occur after only 1 session but to be fully effective a series of 3 sessions scheduled 6 weeks apart with an annual touch-up is recommended.  In severe cases, patients may require additional treatments.

Karny Jacoby, MD
Seattle Urologist
5.0 out of 5 stars 5 reviews

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.