Palm Beach Center for Pelvic Health: Linda A Kiley, MD
Urogynecologist located in Palm Beach Gardens, FL
The drop in estrogen that comes with menopause or even during breastfeeding after delivery causes physical and emotional changes that may have a significant impact on comfort and quality of life. Among the most bothersome problems is atrophic vaginitis, which is the lack of nourishment and hydration of the cells of the vaginal mucosa. This condition causes a progressive thinning of the vaginal and vulvar mucosa which then becomes more delicate, sensitive and more exposed to trauma.
Vaginal dryness and irritation may be a result of atrophic vaginitis, which is often not discussed because some consider it a natural consequence of menopause and postpartum. Thanks to innovative laser techniques, this problem can now be treated in a safe and painless way.
What is vaginal and vulvar atrophy?
Atrophy is a condition in which the walls of the vagina and vulva become thinner and dryer due to a decrease in estrogen. It affects around 40 percent of women, particularly after menopause, and can cause painful intercourse, vaginal dryness, burning and decreased urinary tract health resulting in pain with urinary frequency and even recurrent urinary tract infections.
What treatments are available for vaginal atrophy?
Until recently, traditional therapies for vaginal atrophy included hormonal treatment such as estrogen, an oral medication called Osphena, and a variety of vaginal moisturizers and/or lubricants. Many women are unwilling or unable to take hormones either because they are breast or uterine cancer survivors or because they have tried hormone therapy without success.
Fortunately, there is a new non-hormonal treatment called MonaLisa Touch™ that has been shown to be very effective in treating this problem.
What is the MonaLisa Touch™ Therapy?
MonaLisa Touch™ is a minimally-invasive treatment designed to improve the health and pliability of the vaginal mucosa (inner lining of the vagina). A specially designed CO2 fractional laser is used in an office setting to treat an atrophic or thin and sensitive vaginal wall. The laser has the unique ability to bring penetrating light (laser) energy deep into the layers of the vaginal wall in a manner that stimulates collagen and returns the vaginal tissue to the condition present prior to the changes induced by menopause or other causes.
How successful is the therapy?
Studies from Europe have demonstrated a significant improvement in the symptoms beginning as soon as a few weeks following the first treatment. A recent study performed at The Christ Hospital and Stanford University (the first US trial) confirms these findings.
How many treatments are necessary?
The recommended treatment program is three treatments, each six weeks apart. This usually allows a significant or complete relief of symptoms for approximately one year, after which another treatment session is usually required.
Is the treatment painful?
No anesthesia has been necessary for any patient prior to or during treatment. The procedure is done in a simple manner by placing a small probe in the vagina (see illustration) with minimal to no discomfort. The treatment session lasts approximately five minutes, and no post treatment pain medication is required.
Are there any post-treatment restrictions?
As mentioned, most women have minimal to no pain with the therapy, however, a few women may note some slight localized discomfort. Full activity is usually resumed within 24 to 48 hours.
Are there any side effects or complications?
Even though this therapy is relatively new to the United States, patients in Europe have experienced no long-term side effects. Also, to date no patients treated in the studies at The Christ Hospital and Stanford University have reported any serious side effects or adverse events.