MonaLisa Touch



MonaLisa Touch® is a relatively new treatment in the United States that has been used extensively in Europe. Now that it has FDA clearance it is becoming a much more popular treatment for symptoms related to vaginal atrophy. As estrogen levels decline, some women experience symptoms including chronic vulvar and vaginal itching and burning, painful intercourse, mild urinary incontinence, urinary urgency and nighttime urinary frequency. MonaLisa Touch® reverses these frustratingly common issues quickly and effectively in 3 easy treatments.

Why you should consider it

When it comes right down to it, this treatment is about improving your quality of life. In our office, we have cared for many women who jump through incredible hoops with medications to improve their vaginal health. Every week we see many women with vaginal symptoms for which there are limited therapies: from vitamins and probiotics to vaginal hormonal creams or tablets to lubricants of all types; women try all sorts of things to improve the way they feel, both during intercourse or just in general. While using hormonal remedies, many worry about how these medications affect their risk of cancer. The cost of these medications can be quite substantial as well. I recently spoke with a patient with insurance who pays $300 out of pocket per month for her vaginal estrogen cream. She doesn’t like using it because it is messy and doesn’t entirely give her the relief for which she is looking. We have several other patients using Osphena® a nonhormonal oral medication used to increase vaginal lubrication. This also is very expensive and has the unfortunate side effect of increasing vaginal discharge all the time, not just during intercourse when it is most desired.

So it comes down to a quality of life issue. MonaLisa Touch® is a non-hormonal alternative that happens to work extremely well. It is expensive, like many of the other treatments women are trying. Although expensive, it is also incredibly simple: Three 5-minute treatments spaced 6 weeks apart. It is associated with an 80-90% decrease in frustrating symptoms. About 91% of women surveyed feel MonaLisa Touch® is definitely “Worth It” on

What happens in the office

I always recommend an examination prior to the first treatment to make sure that each woman is an appropriate candidate.

When you come into our office for a complimentary consultation and evaluation we will ask a series of questions to determine if this is in fact an appropriate treatment for you. We will perform a brief examination to determine if you will require an internal as well as external treatment. The internal treatment is geared more toward vaginal tissue, treating vaginal itching and painful intercourse, as well as mild urinary incontinence and other urinary symptoms. The external procedure is geared toward treating external symptoms of itching and burning. We typically do both at the same time, because we feel it is a more thorough treatment. During this visit you will be given instructions for when you return for the actual treatment session.

On the treatment day, we will apply a numbing ointment to the external part of the vagina. In this way, the treatment is virtually painless. After about 15 minutes, we will begin. A metal probe is placed in the vagina and the internal treatment is started. It lasts approximately 3 minutes. Most patients can sense a vibration sensation only, but no discomfort. Then the external treatment is performed, which takes about 2-3 minutes. Some women will feel a mild sensation of discomfort during this part but that is fairly uncommon. When finished, we will give you a small ice pack and place a soothing gel on the external part of the vagina and you may leave the office and return to your normal activity.

For 1-2 days following, you may have a little irritation on the external part of the vagina. We provide a healing ointment and cleansing pads to be used for post treatment care. Initial results can be felt within several weeks after the treatment, and the benefits will continue until the next treatment as new collagen is produced. A 60% improvement is not uncommon. The next treatment should be scheduled for 6 weeks following the one prior for a total of 3 treatments. Results typically last for longer than a year, after which many patients return for periodic single “touch-up”  treatments.

The Bottom Line

Many women are concerned regarding the cost of the procedure.  MonaLisa Touch® is not currently covered by insurance and likely never will be, because of the expense.   But I try to help women understand cost from a long term quality of life standpoint balancing what they’re currently paying for their medications or other treatments, and what their goals are. Again, it truly is a quality of life issue. This treatment makes intercourse more comfortable, and provides relief for women with vaginal issues that affect them both physically and emotionally. Ultimately, each woman will have to put a price on that.

If you are interested in exact pricing, please call my office and speak with either Jennifer Boyce, Dr Wells, or our coordinator, Heather.

I would love to have the opportunity to speak with you more about this exciting quality of life enhancing treatment! Please let us know if you have any other questions. Please call Heather in our office (925) 935-5356  when you are ready to set up a free consultation.

Frequently Asked Questions

The Issue
Even with the passage of time, many women still retain their youthful energy and enthusiasm, but post-menopausal changes can affect a woman’s quality of life in unexpected ways. Hormone replacement therapy may not be the best option for a lot of patients, as treatment outcomes can be uncertain. Now there is an alternative therapy for vaginal revitalization that can help millions of women who are silently suffering and unable to undergo other treatment options. Are you a candidate?

What is the MonaLisa Touch?
MonaLisa Touch is a medical laser that delivers controlled energy to the vaginal tissue to revitalize the cells in the vaginal mucosa (vaginal tissue) so that these cells make more collagen, an essential ingredient in vaginal cell health.

How does it work?
MonaLisa Touch implements CO2 laser energy that is delivered via side-firing probe inserted into the vaginal canal. A two-part pulse targets surface (epithelial) tissue and deep (lamina propria) tissue to promote vaginal mucosal revitalization.

What clinical trials have been conducted on the MonaLisa Touch?
To date, thousands of women have been successfully treated with the MonaLisa Touch globally.

A multisite study was conducted by Dr. Mickey Karram, Director of Fellowship Program on Female Pelvic Medicine & Reconstructive Surgery at The Christ Hospital, Cincinnati, OH and Dr. Eric Sokol, Associate Professor of Obstetrics and Gynecology at the Stanford University Medical Center. Preliminary findings from a trial evaluating the laser treatment on postmenopausal women* and breast cancer survivors experiencing vaginal health issues show positive results.

The trial assessed the use of CO2 fractional laser therapy on 30 women with vaginal health issues due to natural or induced menopause. All of the patients in the trial were treated with The MonaLisa Touch laser.

Does the procedure hurt?
The procedure is virtually painless and requires no anesthesia. Some patients may experience some discomfort the first time the probe is inserted, but the actual treatment is not painful. Many patients report that it feels like a gentle vibration.

How long does it take?
Patients receive three treatments, spaced six weeks apart, which each take less than five minutes to perform.

When will I see results?
Most patients feel improvement after the very first treatment, although the procedure calls for three treatments that are generally spaced over a 18-week period.

How long does it last?
Patients should expect to come back annually for a maintenance treatment. MonaLisa Touch was first available outside the US where more than 5,000 patients have been treated worldwide with up to an 18-month follow-up.

What are my limitations after the procedure is done?
Patients should refrain from sexual activity for 2-3 days. Your doctor will determine a post-procedure regimen that is right for you.

For which patients is this treatment appropriate?
The MonaLisa Touch is appropriate for any female who has gone through menopause, as well as those who are experiencing post-menopausal symptoms as a result of a hysterectomy or breast cancer treatments.

How much will the procedure cost?
Patients should contact our office for additional information.

Is this procedure safe for women with breast cancer?
Yes, MonaLisa Touch treatment is particularly well suited for patients who cannot, or prefer not to receive estrogen therapy.

*Women in the study either experienced natural menopause or induced menopause as the result of hysterectomy or drug-induced suppression of ovarian function (chemotherapy, radiations, anticancer drugs such as Tamoxifen)

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