" What The Heck Is Vaginal Laser Therapy, And Should You Try It? "

What The Heck Is Vaginal Laser Therapy, And Should You Try It?

Apparently it's not painful.

Along with pesky chin hairs, hot flashes, and a tendency to thicken around the middle, many menopausal women also get stuck with vaginal atrophy, which means the walls of the vagina become thinner, drier, and more easily inflamed. For pretty obvious reasons, atrophy tends to lead to dyspareunia, more commonly known as painful intercourse.
Vaginal atrophy happens because estrogen levels plummet. "Some women get it a year after menopause and some don’t get it for 10 years,” says Lila Nachtigall, MD, a professor in the department of obstetrics and gynecology at NYU Langone Health. But rest assured, it’s coming!
Besides turning penetrative sex into an unpleasant experience, untreated vaginal atrophy can also cause itching and burning. Lubricants can help ease the pain of penetration a bit, but Nachtigall believes the first course of treatment should be estrogen. That doesn't necessarily mean taking a pill, especially since studies have found that there are a lot of downsides associated with oral hormone replacement therapy. But the risks of localized estrogen—creams, suppositories, or rings—tend to be much lower, since the hormone doesn't need to go through your bloodstream to get where it's most needed.
Along with these more traditional methods, one relatively new treatment that’s been getting some attention is a laser therapy called the MonaLisa Touch. Maria Sophocles, MD, who runs Women’s Healthcare of Princeton, was one of the first physicians in the U.S. to be trained on the FDA-approved machine, and she sings its praises for treating both vaginal atrophy and the urinary incontinence that often comes along with it. (Aging is not for sissies!)
What you should—and shouldn't—be doing to keep your lady parts in good shape:
the laser makes minuscule injuries to the vaginal walls. “The pin pricks only cover about 8 percent of the surface of the vagina, but the body responds by making new collagen and encouraging blood flow, which elicits a healing response.” This ends up thickening the vaginal walls, and it serves the secondary purpose of propping up the urethra and bladder, which often helps incontinence issues.
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Unlike laser tattoo removal or laser skin resurfacing, which can be quite painful, Sophocles swears this treatment doesn’t hurt. For one thing, there are fewer pain receptors inside the vagina than there are on the skin, and these laser “pin pricks” don’t go very deep. “The depth of penetration is so minimal that it doesn’t reach the pain receptors,” Sophocles explains. You might also feel better knowing that the treatment only takes about 10 minutes.
The catch—you knew one was coming, right?—is that this isn't a one-time thing. Patients who opt to use the MonaLisa Touch are advised to sign on for a course of three treatments, spaced six weeks apart. And the entire process may need to be repeated each year, although results vary.
Another consideration is cost. The price tag ranges from $500-$1,000 per treatment (that's $1,500-$3,000 for a series), and your insurance will almost definitely not pay for it.
Nachtigall says the treatment doesn't seem to have any side effects, and that it's worthwhile for some women; two of her patients have tried it and had good results. But it doesn't work for everyone, so you might spend a lot of money for nothing. And cost will certainly be a major barrier for most people. For that reason, “I would think of it as a last resort for someone who is allergic to estrogen or there’s a medical reason why she can't use it,” she says, like a history of breast cancer.
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If you're not a candidate for estrogen therapy and can't afford to shell out for laser treatment, Nachtigall says you might consider a new product called Intrarosa. It's an over-the-counter DHEA capsule you insert into the vagina once a day. DHEA, a "precursor" hormone, is used by the body to create estrogen and androgen hormones. While Intrarosa is less expensive than laser therapy, it’ll still run you about $200 a month, depending on your insurer—assuming you're lucky enough to have coverage.
Whether you opt to try any of these treatments or just stick with lots of lube, perhaps the most important thing you can do is recognize that you're entitled to a happy, healthy sex life beyond your reproductive years. As Sophocles points out, restoring intimacy to a woman who previously found sex too painful means "giving her back some of her identity." And that’s important at any age.
The article What The Heck Is Vaginal Laser Therapy, And Should You Try It? originally appeared on Prevention.