MonaLisa Touch®

PARVEEN S. VAHORA, MD, FACOG – TRINITY, FL



Mona Lisa procedure
“For whoever is tempting considering the Mona Lisa Touch procedure, I would say, just do it!! I kept hearing about it and I was not sure I really needed it, I felt like my sex life was okay, so I thought. For my 40th birthday, I decided to do it and see if I could make it the best year yet. I cannot believe the difference it has made in my intimate life. I constantly am constantly “wet” and never need to use lubrications. I have had orgasms that I didn’t even know I could have! My partner is very ecstatic and it has brought us closer together as a couple. Best gift I could have ever given to myself, I would do it again in a heartbeat.”
J. McCormick

Mona Lisa Procedure

As we age, every part of our bodies develops and changes. The vagina is no exception, and it is common for women to experience vaginal dryness, vaginal laxity, incontinence, or pain with sex at some point in their lives—in particular, after major life events such as childbirth and menopause. Thankfully, the cutting-edge technology of the MonaLisa Touch can help some women treat these symptoms and regain their sexual health and well-being.

The Mona Lisa procedure uses a CO2 laser, much like facial laser treatments used in dermatology offices, to revitalize vaginal tissue and stimulate collagen growth. Dr. Vahora most commonly recommends it for post-menopausal or perimenopausal women. However, it can benefit a wide variety of people, including anyone who is experiencing vaginal itching, irritation, pain with intimacy, vaginal dryness, vaginal atrophy, incontinence, and prolapse. New moms and mothers who’ve been breastfeeding for a long time can benefit as well. Since it helps reduce dryness and pain during sex, it can improve couples’ overall sex life, and Dr. Vahora has seen patients report increased libido as well.

The Mona Lisa procedure can be safely and effectively used for women who’ve had a hysterectomy, cancer, lichen sclerosis, those who can’t or don’t want to take estrogen, or those who are already on hormone therapy.

COMMON QUESTIONS ABOUT
MONALISA TOUCH®

What is the process for getting MonaLisa Touch treatment?

Patients start the process by coming in for a routine wellness check or for a consultation about a specific problem, and this initial appointment is typically covered by insurance. If you and Dr. Vahora decide the MonaLisa Touch is likely to help your symptoms or vaginal health, you’ll begin treatment. This will be a series of three in-office appointments scheduled one month apart from each other. Each appointment lasts approximately 15 to 20 minutes. The device will be placed in the vagina, and while most patients don’t need it, Dr. Vahora does offer numbing cream both before and after treatment.

Is MonaLisa Touch painful?

Some patients report slight discomfort during the MonaLisa Touch treatment, but there is no pain associated with the treatment. Most people say it simply feels like having a vibrator in the vagina.

What is the recovery after Mona Lisa procedure like?

The Mona Lisa procedures is an outpatient treatment and is performed in Dr. Vahora’s office. There is no recovery time or time off work required. Dr. Vahora tells patients to avoid placing anything in the vagina for two days after treatment, but they can have sex as soon as two days after.

How soon will I notice results after MonaLisa Touch?

Most of Dr. Vahora’s patients see 20–80 percent improvement after their first treatment, and patients typically start to see results after 5 to 7 days. With each treatment, they’ll see more improvement, but the entire process needs to be completed in order to maximize the benefits. Occasional maintenance treatments are recommended to ensure lasting effects.

How many MonaLisa Touch treatments do you need?

A complete round of treatment consists of three 15- to 20-minute appointments, scheduled one month apart from each other. To make sure the benefits last over the long term, Dr. Vahora also recommends that patients come back for one maintenance, or touch-up, treatment per year.

Is MonaLisa Touch safe?

Yes, the MonaLisa Touch uses a low-level laser. The device has been cleared by the FDA for use in the body, although not specifically for use in the vagina. However, doctors often use treatments or medications for purposes that aren’t specifically FDA approved; one example of this is prescribing birth control pills to treat heavy periods. In addition, use of the MonaLisa Touch device to treat vaginal issues has been deemed appropriate in peer-reviewed medical literature. Studies have shown no negative side effects, and none of Dr. Vahora’s patients has seen any negative side effects from treatment.

The MonaLisa Touch device has been approved to treat vulvo-vaginal atrophy in Europe, where they have years of experience and a wealth of data to support its use for this purpose.

MonaLisa Touch is the only vaginal laser system supported by peer-reviewed journals. Some other devices mimic this treatment, and concerns have been raised about those. Of the 12 complaints the FDA has received since December, none were significant, and all were related to devices made by other companies, not the MonaLisa Touch.

Do I need to see a gynecologist for MonaLisa Touch?

While other types of offices might offer MonaLisa Touch, it is best to see a gynecologist for this type of treatment because they have specialized knowledge about the vagina. A trained gynecologist can evaluate the entirety of your health and medical concerns and will create a complete treatment plan that could include other treatments or medications that would give you the best possible results.

Is MonaLisa Touch covered by insurance?

At this time, the treatment is not covered by insurance. The charge for complete MonaLisa Touch treatment is $2,250 for three in-office treatments. Additional touch-up treatments cost $750 each. You can use FSA or HSA as payment because this is a medical procedure conducted in the doctor’s office.

The Issue

Even with the passage of time, many women still retain their youthful energy and enthusiasm, but postmenopausal changes can affect a woman’s quality of life in unexpected ways. Hormone replacement therapy may not be the best option for a lot of patients, as treatment outcomes can be uncertain.Some women still experience vaginal and vulvar atrophy/dryness even with hormone replacement therapy. Now there is an alternative therapy for vaginal revitalization that can help millions of women who are silently suffering and unable to undergo other treatment options.

What is the MonaLisa Touch?

MonaLisa Touch is a medical laser that delivers controlled energy to the vaginal tissue to revitalize the cells in the vaginal mucosa (vaginal tissue) so that these cells make more collagen, an essential ingredient in vaginal cell health.

What are the benefits of the Mona Lisa Touch?

MonaLisa Touch® allows for a functional restoration of the vagina (Laser Vaginal Rejuvenation), which helps fighting and attenuating symptoms related to vaginal atrophy, a widespread problem among pre and postmenopausal women. Thanks to its action on factors that determine dryness, fragility and loss of mucosal elasticity, this treatment can eliminate troublesome itching, irritation and pain, which become particularly acute during intercourse. The interaction with laser is, in fact, the ideal method to stimulate the collagen contained in the vaginal walls for the rehydration and functional tissue restoration. Its beneficial action can contribute to improve self-confidence and sexual pleasure.

How does it work?

MonaLisa Touch implements CO2 laser energy that is delivered via side-firing probe inserted into the vaginal canal. A two-part pulse targets surface (epithelial) tissue and deep (lamina propria) tissue to promote vaginal mucosal revitalization.

What clinical trials have been conducted on the MonaLisa Touch?

A multisite study was conducted by Dr. Mickey Karram, Director of Fellowship Program on Female Pelvic Medicine & Reconstructive Surgery at The Christ Hospital, Cincinnati, OH and Dr. Eric Sokol, Associate Professor of Obstetrics and Gynecology at the Stanford University Medical Center. Preliminary findings from a trial evaluating the laser treatment on postmenopausal women* and breast cancer survivors experiencing vaginal health issues show positive results. The trial assessed the use of CO2 fractional laser therapy on 30 women with vaginal health issues due to natural or induced menopause. All of the patients in the trial were treated with The MonaLisa Touch laser.

Where can I have this done?

The MonaLisa Touch is an in-office procedure performed in our office.

Is it painful?

No. 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. Many patients report that it feels like a gentle vibration. We do offer our patients the option of a topical anesthetic.

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

For any woman who wants to prevent or treat the vaginal symptoms due to estrogenic decrease (in menopause, after childbirth, after a cancer treatment, or after an eating disturb –anorexia). Most common symptoms vaginal dryness, laxity, burning, pain during sexual intercourse and mild urinary incontinence. MonaLisa Touch® is the ideal treatment for those who are looking for a less invasive procedure, compared to traditional surgical or pharmaceutical treatments. Remember, no one can advise you better about MonaLisa Touch® and what is best for you to achieve best results than your doctor.

How long does it take?

Patients receive 3 treatments, spaced 4 weeks apart, which each take less than ten minutes to perform.

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 the quality of life. These results are possible, thanks to the stimulation of the mucosa, which regenerates and “rejuvenates

Can MonaLisa Touch® be used to treat vaginal laxity?

The term “loose vagina” refers to a condition where the diameter of the vagina has increased. This is often caused by natural yet traumatic events, such as giving birth or tissue relaxation due to a natural ageing process. In these cases, it is essential to evaluate the cause and the state of the vagina to exclude a prolapse or an involvement of the muscles. The CO2 fractional laser allows treating those cases where the “loose vagina” is due to a mucosal tone loss.

When will I see results?

Most patients feel improvement after the very first treatment, although the procedure calls for 3 treatments that are generally spaced over a 12-week period. It usually may take 5-7 days to see any results.

How long does it last?

Patients should expect to come back annually for a maintenance treatment.

Individual results may vary depending on the severity of atrophy, the patient’s age and lifestyle (diet, smoking and so on). You can discuss this with your gynecologist at your follow up appointments.

If you start having a recurrence of symptoms please make a follow up appointment.

MonaLisa Touch was first available outside the US where more than 5,000 patients have been treated worldwide with up to an 18-month follow-up.

What are my limitations after the procedure is done?

Patients should refrain from sexual activity for 2-3 days.

Most women report slight localised discomfort following the laser treatment and during the first few days after the session. Topical anesthetic can be used during this time. Many have reported to have resumed their normal routine after one to three days. During the healing period, it may be recommended to avoid lifting weights or some activities, such as taking a hot bath, or physical exercise or intimacy..

Your doctor will determine a post-procedure regimen that is right for you.

For which patients is this treatment appropriate?

The MonaLisa Touch is appropriate for any female who has gone through menopause, as well as those who are experiencing post-menopausal symptoms as a result of a hysterectomy or breast cancer treatments.

How much will the procedure cost?

Patients should contact the office for a consultation and additional information. Some patients may not be a candidate for this procedure; additional treatment may be offered too.

Is this procedure safe for women with breast cancer?

Yes, MonaLisa Touch treatment is particularly well suited for patients who cannot, or prefer not to receive estrogen therapy or have not been getting adequate results from hormonal treatment.

Will the procedure be covered by insurance?

No processing code has been established.

“My girlfriend had the Mona Lisa you have procedure done and the results have been incredible. I cannot describe how happy it makes me that she is so ready to make love to me. I am having to train harder at the gym to keep up with her!!! I would highly recommend purchasing this for your significant other.”
J Boylan

*Women in the study either experienced natural menopause or induced menopause as the result of hysterectomy or drug-induced suppression of ovarian function (chemotherapy, radiation, anticancer drugs such as Tamoxifen)

Contact the office to set up a consultation to discuss if you are a candidate for the Mona Lisa Touch or other options.

Pareen S. Vahora MD PA
Info@ParveenVahoraMD.com
(727) 376-1536 phone
Text line: 813 548-4412 (answered during business hours only)

mona lisa

The Return of Intimacy

Let’s talk about what goes on behind your bedroom doors. Are things as exciting and satisfying as they once were? Be honest now. Chances are the fires have dimmed a bit over the years. Have you asked yourself why? If your answer is that even though your feelings have not changed toward your partner, intercourse just isn’t as satisfying as it once was, or as it should be. This could be the result of natural aging or childbirth. Don’t feel alone. It’s not uncommon. And there is something you can do about it.

Vaginal revitalization may be the perfect solution for you. Here’s why. As we age, especially after menopause, our estrogen levels lower. It’s natural and as a result our vaginal tissue becomes thinner and drier. When this happens we may experience inflammation, burning, itching, and bleeding. It’s no fun! And there’s more. UTIs (urinary tract infections) can become more frequent; intercourse uncomfortable and even painful; and urinary leaking occurs when coughing, laughing and sneezing.

Another reason for a vaginal revitalization procedure is that our vaginal tissue stretches after childbirth resulting in intercourse that may not be satisfying. As I mentioned, there is something you can do about it. A non-surgical procedure call MonaLisa Touch® helps both younger women by tightening up stretched vaginal tissue and those who are naturally aging.

Does the sound of the word “procedure” strike some fear in you? Stop! MonaLisa Touch® is a treatment, not a procedure. And, think about how wonderful it will be to be intimate with your partner again. Here’s how it works. The treatment is done in my office and doesn’t usually require any anesthesia. You’ll experience a vibration, not pain. And here’s the great news – it’s over in a matter of minutes.

Feeling more confident and excited now? It’s really very simple. A small probe is inserted into your vagina. Laser energy emitted from the probe “awakens” your vagina which then starts forming new blood vessels, while increasing both collagen and elastin. These two proteins are what help restore elasticity to your vaginal tissues.

MonaLisa Touch’s major advantage is that it addresses the reasons vaginal atrophy has occurred rather than just addressing the symptoms. It’s longer lasting, non-hormonal, not uncomfortable, no downtime after the procedure, and it only takes three treatments over the course of a few months. Well, there is one catch, it’s advised that you refrain from sexual activity for a few days after the treatment. That’s a small price to pay to restore pleasure and intimacy in the bedroom!

Here is some additional information to consider regarding vaginal dryness. There are over 300 medications that can cause vaginal dryness, including:

  • Anti-anxiety
  • Anti-cholinergic
  • Anti-spasmodic
  • Anti-nausea
  • Anti-­depressants
  • Anti-­diarrhea
  • Anti­-emetics
  • Anti­-hypertensives
  • Sedatives
  • Diuretics
  • Decongestants
  • Anorexiants
  • Anti-Parkinson
  • Anti-psychotics
  • Broncho dilator
  • Cholesterol lowering
  • Anti­-inflammatory
  • Anti-­convulsant
  • Muscle relaxants
  • Narcotic analgesics
  • Antacids

Antihistamines

Antihistamines work by drying out your mucus membranes to relieve symptoms like congestion—but they also dry out your vagina. The same is true for decongestants, though they’ve been less well studied. Once you stop taking the meds this symptom should go away.

Oral Contraceptives

Most women know that birth control pills can cause issues like weight gain and low libido. But between 3­5% of women on low­dose birth control pills experience vaginal dryness. You can consider switching to LARC and IUD.

Aromatase Inhibitors

Up to 20% of women on aromatase inhibitors discontinue due to the adverse side effect profile; specifically, severe vaginal dryness and painful intercourse.

Remember!

Never stop your medications unless you discuss it with your health care professional. Many people stop taking their medications due to adverse effects and noncompliance may account for more than 10% of older adult hospital admissions and $100 billion in health care costs each year.
But if you think that medications are contributing to vaginal dryness and impacting your sexuality then there may be simple solutions. Use of a safe, effective vaginal moisturizer or lubricant might help. Speak to your health care professional about a possible solution which may include medication change or dose modification.

Medical conditions

Having both a chronic illness and a satisfying sex life can be a challenge. When focused on healing, stability, and self­care, we sometimes forget about pleasure. If the goal is to battle an illness and live your best life, it helps to remember that a part of that life is the continued ability to enjoy sex and romance.

Both men and women may suffer from chronic medical conditions which can impact the sexual response cycle causing vaginal dryness, erection problems and changes in desire. The effects of chronic illness on sexuality are often complicated. Both the disease and the treatment for the disease may have an impact on sexual function and desire.

Vaginal dryness and pain during sex are two of the more common occurrences for women with a chronic disease. Sometimes the disease itself directly effects sexual function. Diabetes may cause damage to nerves or blood vessels causing difficulty achieving orgasm and extreme vaginal dryness. Thyroid disease may create lower than normal estrogen and testosterone levels leading to lack of libido. Most chronic illnesses will cause a change in your body that will eventually affect your sex organs.

Treatment for these conditions may be tricky but the best way to handle direct issues is to do the best you can at balancing hormone levels. By controlling the chronic disease to the best of your ability, you also help maintain conditions where treatment for sexual functioning can be successful.

A high­quality lubricant like Überlube is a good first step in dealing with dryness and pain. Made of silicone and vitamin E, Überlube does not absorb into your skin so a little bit goes a long way.
Indirect effects on female sexuality happen when medical treatments by therapy, surgery or medication cause signs, symptoms, or side effects that influence your sexual response. Cancer treatments will often force a woman into early menopause. Changes to self­esteem, mood fluctuations and reduced energy are some of the side effects that may also come with treatment of the underlying disease.

If you think that your sexuality has been impacted by a chronic medical condition, here are some helpful hints.

First and most important. Maintain communication with your partner and discuss your concerns. Do not let yourself feel alone and isolated.
Next, make an appointment with a health care professional to ensure your condition is optimally managed. You may want your partner to attend the appointment with you so that they have a better understanding of what’s going on.

Some things you may want to talk about with your healthcare professional:

  • A change in medication.
  • Hormone support.
  • Best practices for general health, specifically diet, exercise and sleep.
  • Stress reduction.

Try some simple solutions to rekindle your libido at home too:

  • Some new bedroom toys. Consult a specialist to find the right vibrator or accessory for you.
  • A luxurious silicone lube like Überlube to prolong sexual arousal and decrease vaginal dryness.
  • Reveal your fantasies and try something new.

Above all, do not remain silent. Sexuality specialists can often address your concerns. Chronic illness is hard enough. Don’t give up the intimacy and pleasure that you desire.