Urogynaecology & Pelvic Reconstructive Surgery,
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Overcoming Vulvar Vaginal Atrophy

Vaginal health is a keystone of femaleness. Vaginal dysfunction, manifested in vaginal discomforts (vaginal dryness, vaginal itch, vaginal soreness, vulvar itch, vulvar pain, vestibular pain), sexual discomfort (dyspareunia, pain during and after sexual intercourse, loss of sex drive) and urinary discomforts (urinary urgency, urinary frequency, urethral pain) occurs in most women at some point in life. Vulvar vaginal atrophy is generally treated by hormonal replacement therapy. The introduction of MonaLisa Touch® by DEKA has ushered in a new era of managing atrophic vaginitis, where CO2 laser is deployed in a fractional pulsatile array (DEKA pulse).

Are You Suffering From Vaginal Dysfunction?

Majority of women suffer from conditions when the vagina gradually loses its function and integrity. These conditions include the months following your giving birth, especially when you breastfed your child, when you receive anti-estrogen treatment, after you have undergone major vaginal surgery, and when you approach the menopause. As vaginal function deteriorates, you will experience vulvar itch, vulvar irritation, vulvar burning, vaginal dryness, vaginal soreness, and pain during and after intercourse, weak control of urine, urethral symptoms, recurrent vaginal infections and recurrent urinary infections. These urogenital symptoms are often ignored and neglected. Surveys have confirmed that women, regardless of race and status, are uncomfortable discussing vulvar and vaginal discomforts. Often they are embarrassed by their occurrence. Consequently women suffered in silence, and endured substantial loss of both quality of life and sexual freedom.

Vaginal Discomforts

Vaginal discomforts arise largely from reduced estrogen effect on the skin, soft tissue and muscles that support the vaginal canal. This condition, culminating in atrophic vaginitis, represents a general lack of nourishment and hydration of the cells forming the vaginal skin (mucosa). As it worsens, the vulvar and vaginal skin becomes thinner, more delicate, more sensitive and more easily traumatized. Women generally ignore the sufferings ascribed to vulvar vaginal atrophy. They accepted them as part of ageing; as had preceding generations of women who had similarly stomached them. Many doctors likewise counselled them to accommodate the inevitable changes of advancing age. Even though pharmacological treatment is available, the unwillingness to apply, and the fear to use proven hormonal replacement therapy become stumbling blocks to better health.

Sexual Discomforts

Pain during intercourse and persistent vulvar and vaginal soreness after sex are experienced in women suffering from vaginal dysfunction. Women become anxious and depressed as these copulatory difficulties continue, eroding their self-confidence and denting their sense of wellness. Their partners’ understanding is helpful, nevertheless, the protracted lack of sexual communication undermines many relationships.

Urinary Discomforts

Lower urinary tract symptoms affects a good number of adult women. Urgency of urine, having to pee many times a day, feeling sting or pain at peeing, and constant indistinct soreness at the pee hole are distressing complaints encountered. Together with the involuntary leakage of urine (or urinary incontinence), these women struggle to control the inconveniences on a regular basis, and to contain the embarrassment. Clinical studies in various centers around the world have attested to the efficacy of using laser therapy in the management of vaginal dysfunction. MonaLisa Touch is the revolutionary intra-vaginal fractional CO2 laser treatment – a painless, minimally invasive and effective approach to resolve vulvar-vaginal atrophy and its associated conditions.

Treatment With Vaginal Laser

MonaLisa Touch® – the all new Vaginal Rejuvenation Program. Using proprietary fractional CO2 laser, MonaLisa Touch® was conceived to counter-act the ravage of low estrogen in the vulva and vaginal wall. MonaLisa Touch® is currently one of most effective non-surgical and non-pharmacological solution for preventing and treating vaginal dysfunctions.

How fractional laser works

The CO2 laser gently acts on the vaginal wall through a special scanning probe. By panning 360 degree of the vagina, the laser treatment produces indistinguishable micro-lesions that are critical in triggering the formation of new collagen and cellular matrix. By augmenting the vaginal skin, the laser treatment improves blood flow into the vaginal complex, thereby restoring adequate nutrient and hormone circulation. The initiate surge of neo-collagenesis reactivates interstitial inter-cellular processes and re-establishes proper urogenital function. Vaginal tissue regeneration process was shown to continue for weeks after the index laser treatment, and the functional restoration persists for months.

After laser treatment, the histological examination detected increased epithelial thickness and better nourished cells. Clinically the vaginal tone improved and become more elastic. The vaginal pH normalizes with return of the natural barrier protection against common infection. In summary, MonaLisa Touch®, a simple laser treatment lasting a few minutes, which is essentially pain-free and has no down-time, can return the vaginal tissue to the tone and elasticity it once had, resulting in significant enhancement in quality of life and personal relationships.

Frequently Asked Questions

What are the benefits of this treatment?

MonaLisa Touch® attenuates symptoms of vaginal dysfunction and its associated conditions. The treatment eliminates troublesome itching, irritation and pain, which become particularly acute during intercourse. Alleviating vaginal atrophy can contribute to your improve self-confidence and sexual pleasure.

Is it painful?

No, the treatment is not painful, and it does not require anaesthesia. You may report a light vibration in the vagina when the laser is activated.

For which women is MonaLisa Touch® laser treatment most suitable?

You are at risk of vaginal atrophy at some point in your life. You will benefit from it if you desire to prevent or treat the discomforts of vaginal dysfunction (see previous section). Most common symptoms include vaginal dryness, vaginal laxity, vulvar burning, and pain during intercourse and mild urinary leakage. MonaLisa Touch is ideal for you who are unwilling to use, or are unable to tolerate pharmaceutical remedies; and also for you if your condition is not severe enough to have surgical correction.

What type of results can I expect?

After vaginal laser therapy, you can expect gradual resolution of your initial vaginal discomfort.

Can MonaLisa Touch® be used to treat vaginal laxity?

Vaginal laxity or “loose vagina” refers to a vagina with increased capacity, caused by a reduced tone of the stretched vaginal skin, ligament and muscles. It occurs commonly after first and repeated vaginal deliveries, made worse by low estrogen state and advancing age. When it becomes severe, you will present with prolapse of the pelvic organs. Vaginal laser therapy may benefit vaginal laxity by improving the tone and integrity of the skin interstitium, enabling your vagina to feel more responsive and firmer.

Are there any risks?

There is no systemic risk or complication. It is an outpatient procedure, painless with no down time. You may report transient minimal vulvar redness and or swelling, which resolve shortly.

How many treatments are needed?

The number of treatment sessions depends on the severity of your vaginal dysfunction and the outcome that you expect to have. We recommend one to three treatments, performed between forty and sixty days apart, and follow by a yearly maintenance treatment. Your gynecologist will prescribe the eventual regimen after a careful evaluation of the severity, the cause and your functional needs.

How is the recovery?

You will experience mild vaginal discomfort following the laser therapy, which may last for a few days. You will return to normal routine after one to three days. You are recommended to avoid spots, physical activities and long baths during the healing phase. Your gynaecologist will further instruct you of any specific after-care.

How long do the effects of the treatment last?

Symptom relief is felt soon after the first treatment session, and continues to improve over the next few months. Clinical studies established that the cellular regenerative processes will last between forty and sixty days. You will be advised on a follow-on maintenance treatment session at the appropriate time.

Are there any contraindications?

Anyone who is healthy and well may embarked on the MonaLisa Touch ® program. Nonetheless, if you are suffering from other chronic medical ailment, a thorough consultation with your gynaecologist is necessary to determine if vaginal laser therapy is suitable.

How soon can I resume sexual activity?

We recommend three to four days of rest before resuming regular sexual activity. In any case, your gynaecologist will instruct on more specific guidance during the post laser review.

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