When a woman’s estrogen declines, it can lead to vaginal atrophy — drying and irritation that cause pain during intercourse and other symptoms.
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These symptoms aren’t just uncomfortable. In some cases, they hinder your quality of life.
But a new laser treatment provides many women with relief.
The vaginal laser treatment, MonaLisa Touch, was approved by the U.S. Food and Drug Administration for gynecologic use in 2014. It uses laser technology to help treat vaginal atrophy and possibly other issues, such as incontinence.
Marie Fidela Paraiso, MD, section head of urogynecology and reconstructive pelvic surgery at Cleveland Clinic, explains how the process works — and who benefits.
How it works
After examining a patient to rule out infections, a doctor applies numbing cream to the vaginal opening. The laser treatment, which takes minutes to perform, places tiny holes in the vaginal lining. This treatment results in new blood flow and healthy tissue growth.
“Vaginal biopsies have proven that the vaginal wall grows thicker with stronger and more elastic tissue and new blood vessels,” Dr. Paraiso says.
In basic terms, the process “remodels” the vagina with healthier tissue. The course of treatment typically involves an initial procedure, followed up by two more treatments that are six weeks apart.
What are the benefits?
Women with a variety of gynecologic problems may benefit from vaginal laser treatment.
Some women suffer from vulvovaginal atrophy after menopause. The vagina becomes dry and sometimes smaller, causing pain during intercourse.
“In some cases, women with this condition can’t have intercourse at all,” Dr. Paraiso says. If you have these symptoms, you may be a candidate for vaginal laser treatment.
The treatment also may be ideal for women who can’t take or don’t want to take vaginal estrogen — or who haven’t responded to it or a similar therapy. This includes women who’ve experienced vaginal atrophy after breast or ovarian cancer, for whom vaginal estrogen may not be an appropriate treatment.
It’s also been used to treat lichen sclerosis, a chronic problem of thinning and irritation of the vulvar skin.
“Outside of the realm of gynecologic conditions, vaginal laser treatment has had a secondary effect in treating urinary incontinence and urgency; however, it is not FDA-approved for this indication,” Dr. Paraiso says.
Do clinical studies support it?
Several pilot studies support the effectiveness of this treatment, Dr. Paraiso says.
One study that tested this method in 50 women over 12 weeks showed marked improvements in symptoms. In the study, 84 percent of women reported satisfaction with the procedure.
In another study of 120 patients, nearly 90 percent reported a reduction in pain during sexual intercourse following this procedure.
Are there drawbacks?
The treatment is relatively new, so the cost is not likely to be covered by insurance.
There’s also no formal billing code for this treatment, though Dr. Paraiso says that the studies that she will soon start are a step toward making that happen.
“I’ve designed a clinical trial to compare this therapy in women who do not have contraindications to vaginal estrogen, don’t want to take estrogen, or haven’t responded to vaginal estrogen. We will compare vaginal laser therapy to vaginal estrogen, which is the first-line therapy for vaginal atrophy and its associated symptoms.”
As for side effects, patients undergoing this treatment might initially experience vaginal discharge or bleeding, but relief should follow in as little as 2–3 days.
Dr. Paraiso is optimistic about the future of the treatment. “Our patients deserve effective treatment for vaginal atrophy and improvement of related menopausal symptoms and sexual function,” she adds.