Almost half of women in the United States suffer from symptoms of declining estrogen, including the uncomfortable condition of vaginal atrophy. The atrophy causes thinning, drying and inflammation of the vaginal walls which leads to painful intercourse and problems with urination. Now there is hope for these women through the use of a laser therapy called MonaLisa Touch®.
Approved by the Federal Drug Administration (FDA) in 2014, the therapy has been used on thousands of women, according to Heidi Straughn, MD, an OBGYN at Brookwood Baptist Medical Center. Brookwood, St. Vincent's Hospital and Urology Associates of Alabama currently are the only clinics in the Birmingham area using the therapy. "The treatment has been a wonderful thing," Straughn says. "I am glad to be able to offer it to my patients."
The treatment, done in a physician's office, is designed to stimulate and promote the regeneration of collagen and the elastin fibers and the restoration of hydration and elasticity within the vaginal epithelium and mucosa. "The laser releases energy through a special pulse, and the laser energy penetrates to a depth that stimulates the synthesis of new collagen," Straughn says. "This results in more thickness and ruggation of the vaginal tissue, increased glycogen and hyaluronic acid, and decreased pH, all of which restores the vaginal tissue back to its healthy condition prior to the decrease in estrogen."
Straughn says the typical patient is one who has gone through menopause either naturally because of age or because of surgery to remove the ovaries. Breastfeeding mothers and breast cancer patients undergoing chemotherapy also may develop symptoms. "These women may not want to or can't take hormone therapy. Others are choosing alternatives because of perceived risks, side effects or the cost," she says.
The MonaLisa Touch® addresses a number of the issues that cause vaginal atrophy and may especially benefit patients who have a past history or family history of breast cancer and may be advised to forego hormone therapy. "It also helps with urinary frequency and urgency symptoms. A lot of older women make frequent trips to the bathroom at night. After the MonaLisa Touch® therapy, the decrease in urination frequency is one of the first things they notice," Straughn says.
Many patients are surprised that the procedure is relatively painless. "We use a numbing cream prior to the procedure," Straughn says," but I have never had a patient even flinch while undergoing the laser therapy."
The physician uses a fractional laser with a vaginal probe which is inserted into the vagina. The probe delivers laser energy pulses to create small injuries in the epithelial layer of the vagina mucosa which triggers fibroblast activity to stimulate new collagen production. Three five-minute treatments six weeks apart are required to begin the therapy. Straughn says the patient with will return every one to two years for a follow-up treatment. "Most women have dramatic improvement after the first treatment," Straughn says. "They have increased blood flow and increased collagen, all the things you expect to be present when a woman is 20 years old, not at 55. It basically returns the vagina to its pre-menopausal state."
Straughn says gynecologists can refer their patients to her office just for the MonaLisa Touch® therapy. They don't have to change doctors. She wants all women who are suffering from these symptoms to be able to take advantage of this new therapy. The one downside is that the procedure is not covered by insurance. "Most women want the procedure to be done anyway. Besides, when you look at the money women spend on vaginal estrogen therapy which can cost up to $300 a tube and often isn't covered by insurance, the MonaLisa Touch® doesn't cost much more," Straughn says.
"The physician who did my training has done more treatments than anyone in the United States, and he says the cure rate is almost 100 percent," Straughn says. "Use of this therapy is rapidly growing, and I hope it becomes widespread. Few therapies have a cure rate like this, and patients are satisfied. It just works."