Dr Manny's Notes

Is laser treatment for vaginal atrophy safe?

Manny Alvarez

Every year, millions of women in the United States suffer post-menopausal changes in their lives, including symptoms of vaginal atrophy. Many women ignore or cope with mild symptoms, but others seek treatment for issues like urinary incontinence, vaginal burning and itching, and painful intercourse. In the past decade, many women have been turning to a new laser treatment for answers, but is it safe?

The Monalisa Touch

In the world of vaginal atrophy, the Monalisa Touch could potentially solve the problem for good. Unlike other procedures, this new laser treatment requires no anesthesia, and patients can return to sexual activity in a matter of days.

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The laser works by gently stimulating vaginal tissue, helping it to produce more collagen and strengthen the tissue. The Food and Drug Administration approved this treatment in late 2004, and many women have attested to reduced symptoms of atrophy and restored sex lives since.

For now, insurance companies do not cover the Monalisa Touch, and patients must pay an average $2400 out of pocket to receive the treatment. Still, women weigh the options and find this costly treatment worth the price.

In addition, the Monalisa Touch often resonates with cancer patients and other groups who cannot undergo usual treatments for vaginal atrophy. Normally, doctors recommend lubrications and vaginal creams to reduce pain during intimacy. If this treatment does not work, they move onto hormone replacement therapy, using estrogen.

For some women, especially cancer survivors, this treatment just is not an option. In 2002, researchers linked hormone replacement therapy to an increased risk of breast cancer, and combination therapy increases that risk by 75 percent. Other women forgo the hormone therapy for personal reasons, wanting a more permanent answer to their problems.

Does Laser Treatment Work?

According to proponents of the Monalisa Touch, the laser treatment works in over 90 percent of cases with little to no side effects. Patients can continue normal activities, with a small period of sexual abstinence, and do not need anesthesia for the minimally invasive procedure.

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In addition, the Journal of Endometriosis and Pelvic Pain Disorders found that 100 percent of patients had improvement in painful intercourse after 12 weeks of receiving treatment.

On the other hand, women should understand that the process in which lasers receive approval by the FDA has much less regulation than do drugs. In addition, most of the research performed with the laser have been relatively small trials with no control group.

For example, one 2015 study evaluated 77 patients with vulvovaginal atrophy and followed the results until the 12-week checkup. Of the women who participated, 20 women were sexually inactive due to vaginal atrophy.

The researchers found that 17 of the sexually inactive women were able to return to normal sexual activity before the 12-week checkup. However, this particular trial did not have a control and alternate group with which to compare the results. Researchers need more testing to verify the laser’s safety and long-term effects.

Side Effects and Complications

To date, most women who undergo the laser treatment may report itching, burning, redness, or swelling immediately following the procedure. However, these complications do not last more than a few days. Researchers have found no other long-term effects associated with the treatment.

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At the same time, have the less stringent clinical trials done enough to rule out long-term effects? While the positive results of the small trials do offer much hope to suffering women, they may need to answer a few more questions.

In the 2015 trial, researchers did not track the women’s long term progress for potential regression or other resulting health problems. The Monalisa Touch shows great promise, but people should know exactly what they’re getting into long term.

Even still, thousands of women have already received treatment since the laser’s release. So far, women have not brought up any major health issues related to the procedure. In fact, the laser treatment has helped many women renew their sex lives and gain freedom from vaginal atrophy.

Laser treatment for vaginal atrophy has shown promise in helping women manage crippling post-menopausal symptoms. These women simply do not want to live the rest of their lives suffering from itching, burning, and painful intercourse. However, women should consider that there might be unknown risks for them long-term, although none have come up thus far. They should make the decision carefully with the help of a healthcare professional and choose the best option for their situation.  

This article first appeared on AskDrManny.com.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.