FAQ: MonaLisa Touch

Carbon Dioxide Microablative Laser Therapy


What is it?

CO2 Microablative laser therapy (CDML) is an emerging therapy to restore health to vaginal tissue. MonaLisa Touch (MLT) is the  name of the laser unit developed at San Raffaelle Hospital in Milan, Italy. Hence the nod to the enigmatic muse of Leonardo DaVinci.

What is it used for?

CDML is used to treat vulvovaginal atrophy (VVA), a chronic, progressive condition caused by a lack of estrogen.  It is usually due to menopause, but it can occur before menopause from premature ovarian failure, chemotherapeutic or other medications, and after pregnancy.

In VVA, vaginal and vulvar tissue thins and loses elasticity.  There are fewer blood vessels to supply nutrients and water to cells.  The vaginal opening may become constricted and vaginal length can shorten.  The vaginal pH rises which can lead to genital and urinary tract infections.  Even urinary function can be affected.  Symptoms include dryness, itching, bleeding, pain with intercourse and urinary dysfunction.

How does it work?

The laser supplies light energy to the vaginal walls, targeting water under the surface.  Hundreds of tiny “pin pricks” are “stamped” 360° around the full length of the vagina.  These are very superficial -- only 200-600 microns deep -- and painless, but they stimulate a healing response.  Special proteins stimulate development of new blood vessels, moisture-making cells, and fibroblasts, which produce new collagen.

What type of results can I expect?

Most treated patients report a reduction in dryness, burning sensation, pain during intercourse, and urinary symptoms which contributes to a substantial improvement in  quality of life.  You may notice increased normal vaginal discharge as vaginal tissue becomes healthier.

Where can I have this done?

The MonaLisa Touch is an in-office procedure done in our office. In fact, Women’s Healthcare of  Princeton was one of the first practices in the U.S. to adopt this technology and we have performed more procedures than almost anywhere else in the country.

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.  We recommend trimming long pubic hair prior to the procedure.  We can apply topical anesthetic if necessary.

How long does it take?

The actual treatment takes less than 5 minutes.

When will I see results?

Most patients feel improvement after the very first treatment, although the protocol is three  treatments over a 12 week period.

How long does it last?

Patients should expect to come back annually for a single maintenance treatment, although some patients may not need any further treatments.  Use of vaginal or oral medication may prolong the results and benefits of CDML.

What are my limitations after the procedure is done?

Refrain from sexual activity for 2-3 days.  Your doctor will determine a post-procedure regimen that is right for you.

What to expect post-procedure.

Most likely you will not notice anything different but you may experience slight spotting or mild discomfort.   

What are other options to treat VVA?

Lubricants, vaginal estrogens or an oral, non-hormonal treatment.  Lubricants decrease friction but do not heal or improve tissue.  The two medical treatments also take about 12 weeks to work. These can be used in conjunction with Mona Lisa Touch.

Are there any contraindications?

Radiation therapy to the pelvis or insertion of vaginal mesh are contraindications. If you have an active genital infection such as herpes or even yeast, please let us know. We recommend these be treated prior to the procedure.

Is this the same as “vaginal tightening” or “vaginal rejuvenation”?
No, it is not.  This is not a cosmetic or medical aesthetic procedure.  This is sophisticated medical technology to treat VVA.  

What other GYN problems does CDML treat?
MLT is FDA approved and is currently being used to treat lower urinary tract symptoms (LUTS) such as urgency, frequency and incontinence, and vulvar disorders such as lichen sclerosis (LS).

Is it covered by insurance?
It is currently not covered by insurance.  Fortunately, we have found ways to make it easier to afford the procedure. Please speak with our office manager for details.

Where can I find more information?
Call our office. We would be happy to help you learn more about this wonderful option.