INTRODUCTION

Like all organs in the body, a woman’s most intimate area is not immune to the effects of time. The female body’s natural decline in oestrogen during menopause can significantly affect the vaginal and urinary structure causing serious problems, such as vaginal dryness, itchiness, irritation, loss of elasticity, discomfort during intercourse, infections and urinary incontinence.

These symptoms affect up to 50% of post-menoapusal women, often reducing libido and having an adverse impact on intimate relationships.  Furthermore, these symptoms may occur in much younger women, especially those in reduced oestrogen states or induced menopause following cancer-related treatments or surgery.

Today, more and more women are turning to medicine and innovative treatments to improve the tone and normal functioning of their genital region; and thankfully, many valuable treatment options are now available.

A relatively new treatment with encouraging results is the MonaLisa Touch laser – a non-hormonal, non-surgical, low-risk, quick and painless procedure. MonaLisa can offer patients an alternative to using traditional HRT vaginal creams (Prescription treatments for Vaginal Atrophy) and requires no downtime. Women can return to normal daily activities following treatment, however, vaginal intercourse and strenuous activity are not advised for 5 days following treatment.

What results are possible?

MonaLisa Touch stimulates the regenerative processes of the vaginal surface and connective tissue to create more hydrated and healthy cells and to improve the vascularity of the vaginal mucosa. This has a direct effect on the integrity and elasticity of the vaginal wall and increases the blood flow and acidity of the vaginal environment to more normal levels.MonaLisa Touch does not replace hormone replacement therapies or surgically installed mechanical supports for all women, but where appropriate offers a less invasive and highly effective option. Women have reported:

  • much better lubrication;
  • more comfortable intercourse (no pain during intercourse);
  • decreased burning or itching sensation;
  • decreased urinary urgency and incontinence;
  • less vaginal infections and odorous discharge;
  • improved laxity and tone (tightening);
  • along with greater sensitivity and ability to orgasm.

As a result of these significant improvements in vaginal and urinary symptoms, patients tend to feel an enhanced femininity, libido and self-confidence allowing them to reclaim control of their body, re-engaging in physical and sexual activities in comfort.

Feelings, sensitivity, orgasm seemed to just flow again….as it should. No more dry, uncomfortable, awkward pain. Sounds a bit unbelievable after one treatment, and I constantly question myself….but its absolutely true!

Clinical results and studies

Whilst relatively new, more than 4000 patients have been treated in Australia since 2013 and many tens of thousands of patients abroad, with exceptional results for nearly all women.

The idea of using a fractionated CO2 laser to revitalise the uro-vaginal tissue came about via discussions between a Dermatologist and Gynaecologist. The Gynaecologist – Dr Stefano Salvatore, a professor in Milan Italy, started an intensive research protocol. Dr Salvatore has over 110 published medical papers.

Working in conjunction with a renowned laser company they developed a special laser pulse with a very high peak power over a very short period (60 microseconds) followed by a longer low energy laser ”tail”. This pulse is currently only available with the MonaLisa Touch laser.

Once the laser parameters were established to be safe and giving the desired laser stimulation to the vaginal lining, further studies were conducted and published on the effectiveness of the treatment on vulvo-vaginal symptoms. Professor Salvatore was able to show the MonaLisa Touch treatment was remarkably effective.

The following image shows a histological preparation of a section of the vaginal mucosa. The image on the left shows the vaginal mucosa pre-treatment and the image on the right is the same patient 2 months after a single session with MonaLisa Touch (with the same enlargement). The much thicker epithelium and shedding of numerous big cells from the free surface, together with the larger diameter of the epithelial cells rich in glycogen demostrate restored tissue.

histology

The following chart represent the percentage of reduction for the main symptoms of vaginal atrophy and urinary incontinence after 3 recommended MonaLisa Touch sessions. The study was carried out at the Department of Gynaecology of the San Raffeale Hospital, Milan, on patients with symptoms of uro-genital atrophy: courtesy of S.Salvatore, M.D.

result

 

result-2

When will I see Results and for How Long?

Many patients report immediate changes, especially with increased vaginal lubrication.  However, the stimulation and rejuvenation process, involving cells and tissues, takes a few weeks to be completed. Results will be more noticeable approximately one month after the 1st treatment and will continue to improve.  However, we normally recommend a full cycle of 3 sessions, 30 days apart, to treat vaginal atrophy and incontinence symptoms, which has clinically shown to produce better long-term results (although the number of treatment sessions can be altered according to the level and nature of your symptoms, please discuss this with your physician).

The longevity of the MonaLisa Touch results are generally very good, but the extent and duration of improvement varies between individual patients. Many of the symptoms treated by MonaLisa Touch are associated with low hormone levels brought on by menopause; therefore, a continued lack of oestrogen production can lead to some symptoms returning down the track. Patients can have top-up treatments if their symptoms return, under the advice of our doctors.

For patients wishing to have MonaLisa Touch for laxity, that is, to improve their vaginal tone and tightness following child-birth, good results should be felt after two MonaLisa Touch treatments.  Please discuss this during your consultation to ensure your primary symptoms and concerns are properly addressed.

Other Benefits – vulva tightening and lightening

The Monalisa Touch laser may also be used on the vulva and surrounding skin. If you are concerned about the pigmentation or size of the vulva, the laser may be used in the same way it is on facial skin.

A numbing cream is required for 45 min prior to treatment, as with the face. A light ‘resurfacing’ laser pass is performed. There will be some mild swelling and darkening of the skin. The dark skin then flakes off revealing the improver skin quality and colour. Pigmentation can improve with a single treatment and will improve further with subsequent treatments.

Because the labia are so soft, the beneficial tightening effect on the skin is useful to reduce the size of the labia for someone who is not yet ready or requiring labiaplasty reduction surgery. For effective tightening and reduction in size of the labia, 3 to 4 treatments may be necessary.

NOTE:

It is important to understand that not all women are suitable for the MonaLisa Touch. Each patient must have a consultation to determine their suitability prior to undergoing treatment and some pre-treatment health checks are required. Although the MonaLisa Touch can offer similar results to hormone replacement therapy, some patients may still need to seek further treatment, surgery or medication to alleviate their symptoms.

 

[References: 
CLIMACTERIC 2014;17:1–7, A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study 
Journal or Endometriosis and Pelvic Pain Disorders 2014, Microblative fractional CO2 laser improved dyspareunia realted to vulvovaginal atrophy: a pilot study].

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