Most women know that declining levels of estrogen during menopause can cause hot flashes. What most women do not know, however, is that vaginal tissue is also very dependent on estrogen. As the estrogen levels fall, the vagina becomes thinner, dry and even inflamed, which results in a condition known as vaginal and vulvar atrophy.

A very common and bothersome symptom of vaginal and vulvar atrophy is painful intercourse, which in medical terms is called dyspareunia (dis-puh-roo-nee-uh). But because women don’t necessarily associate dyspareunia with menopause, most who experience it due to menopause unfortunately do not seek treatment.

Historically dyspareunia has been treated with various lubricants and localized estrogen therapy, and recently a medication called Osphena has come to market specifically for this condition. However, medical therapy has proven to be difficult to administer at times, especially higher up in the vagina, and it requires long-term use in order to obtain a desirable effect.

In 2008 a new therapy was developed in Italy that uses a CO2 fractional laser to rejuvenate the vaginal skin, making it more elastic and more moist. The therapy is called the MonaLisa Touch treatment (MonaLisaTouch.com), and to date more than 300 patients have been treated in Italy under a variety of study protocols with excellent results.

To understand how this therapy works it’s important first to understand that the vaginal skin is multilayered and requires estrogen to proliferate and be viable. Within a few years after a woman goes through menopause the vagina dries and becomes very thin. The laser is able to release energy through a special pulse, and the laser energy heat penetrates to a depth that stimulates the synthesis of new collagen. This results in a thickening of the vaginal skin, increased moisture and better lubrication, which restores the vagina to a state similar to before menopause.

This minimally invasive, painless procedure is performed in an office setting and requires no anesthesia. It’s currently done in three treatments (which take less than five minutes each), six weeks apart. The data from Italy seems to indicate that the effects of the treatment last for at least one year before patients need a repeat treatment. This therapy is very well suited for breast cancer survivors who cannot receive estrogen therapy because of the risks estrogen poses for cancer recurrence.

The California Center for Female Pelvic Floor Health is one of very few centers in the United States to offer this procedure. Schedule an appointment to learn more about this revolutionary therapy.