If there’s one thing we can thank the Kardashians for, it’s bringing awkward topics into the light for conversation.

“Vaginal rejuvenation” is one of those awkward topics. Apparently, at least two of the sisters have undergone treatment to “tighten” their vaginas after childbirth.

While we’re not suggesting you play Keep Up with the Kardashians, some vaginal treatments can give women relief from menopausal symptoms, and that’s worth exploring.

What is vaginal rejuvenation?

Just like other parts of the body, the vagina ages over time (thinning, drying, loosening, shrinking) and it may change due to vaginal births. Vaginal rejuvenation therapies are intended to help women regain the moisture, tightness, and elasticity of their younger, pre-childbirth parts. Treatments generally fall into two categories: cosmetic and reparative.

Cosmetic surgeries include labiaplasty, which changes the appearance of a woman’s vagina by reducing the size of the labia – the interior and exterior “lips” of the vulva that protect the clitoris and vaginal opening.

Some cosmetic surgeries change a woman’s sensations during sex: vaginoplasty tightens the vaginal walls which can get stretched in childbirth; or there’s clitoral hood reduction, intended to expose more of the clitoris for greater sensation.

Other options include “revirgination,” surgery intended to return the hymen to its “virginal” state, and “G-spot amplification” wherein collagen is pumped behind the vaginal wall to make the G-spot thicker, more sensitive, and easier to … uh …reach.

Reparative vaginal treatments are intended to do exactly that: repair. Surgical procedures can treat prolapse, for example, where pelvic organs such as the uterus “droop” into the vaginal canal, or they may be able to help with urinary incontinence.

Also, as vaginal walls thin and dry with age, intercourse can become painful; some treatments may make vaginal tissue healthier and more resilient and restore the body’s natural moisture.

Today’s discussion is about reparative vaginal treatments, but if you are considering any type of surgery on your lady parts, please be sure you’re familiar with the risks of vaginal surgery.*

An alternative to surgery – the Mona Lisa Touch

When it comes to ways to combat vaginal dryness associated with menopause, there are also non-surgical options. For many women, lubricants such as genneve’s Personal Lubricant or Intimate Moisture get the job done very nicely, thank you. But for those who also suffer incontinence or atrophic vaginitis, the Mona Lisa Touch (MLT) might be worth investigating.

Dr. Dunsmoor-Su

Dr. Rebecca Dunsmoor-Su

A relatively new technology, the Mona Lisa Touch received FDA approval and has been available in the US since 2014. To better understand how (and if) it works, we talked with Dr. Rebecca Dunsmoor-Su, MD, MSCE, FACOG, a Seattle-based doctor, medical researcher, and educator who offers MLT treatment to her patients at Renuvagyn in Seattle.

What is the Mona Lisa Touch and how does it work?

During and after perimenopause and menopause, lack of estrogen can make vaginal walls thin, dry, fragile, and easily damaged. Women can experience pain during intercourse (or exercise, or even just daily activity like walking and sitting) and an uptick in the number of urinary tract infections.

Uh … no.

The Mona Lisa Touch, according to Dr. Dunsmoor-Su, is a “fractionated CO2 laser” that works by making pinhole-size “injuries” in the vaginal walls. While this may not sound any better than the dryness, these micro-injuries actually prompt the body to send in immune cells to repair the damage. Cells called fibroblasts awaken and pump up the volume of moisture, collagen returns, the pH returns to normal, and healthy vaginal bacteria come back – all Very Good Things.

“Biopsy studies show the Mona Lisa Touch can return the vagina to its pre-menopausal state,” says Dr. Dunsmoor-Su.

Even better, the MLT uses no hormones, making it an excellent option for women with a personal or family history of breast cancer.

“About 50% of my patients are breast cancer survivors,” says Dr. Dunsmoor-Su, “but the Mona Lisa Touch is a great option for any woman who prefers a non-hormonal solution to menopausal symptoms.”

Should I try it?

Studies demonstrate high levels of success with the Mona Lisa Touch. In one Italian study of 20 women, 17 of those women who were not sexually active due to pain “regained a normal sexual life at the 12-week follow-up.” Dr. Dunsmoor-Su cites rates as high as 85-92% for improvement in dryness, burning, irritation and frequent infections, and 50-75% success rate for women with mild-to-moderate incontinence.

Drawbacks to laser treatment?

  1. Cost. Because insurance doesn’t cover the cost of treatments, which average around $2,400, many doctors will recommend that patients exhaust other, covered treatments first, such as HRT.
  2. Commitment. This is pretty minimal, but those considering MLT should be aware that laser treatments can take more than one visit. Dr. Dunsmoor-Su’s patients get three treatments done six weeks apart, and then an annual “touch-up.”

For such high success rates, the drawbacks and risks are extremely low.

So about those “extremely low risks” …

According to Dr. Dunsmoor-Su, the MLT is pretty much risk-free: there’s no hormone exposure, and the laser doesn’t penetrate deeply enough to cause real injury: “For my patients who have treatments on the external vulva, where most of the nerve endings are, they say they have 24 hours of feeling like they have a sunburn down there. We treat it with ice and numbing cream. That’s really it.”

The only other risk might be that the treatment simply doesn’t work. Some women are simply too far past menopause for the fibroblasts to be awakened, or if a woman has had radiation in the area, there may not be any cells remaining to recruit. It’s always worth trying, the doctor says, so she offers the first treatment at a reduced price for women in these categories. If there’s no improvement, they stop.

What is treatment like, and what should I expect?

The treatment is delivered via a thin probe inserted vaginally. The process takes about 3-5 minutes.

How soon do things start to improve?  Almost immediately, says Dr. Dunsmoor-Su. “There’s improvement after the first session,” she says, “with the peak benefits coming after the second. The third gives the treatment longevity so patients don’t have to return for the maintenance for at least a year.”

High success rates, low risk, long-term benefit: For women looking for relief from vaginal issues like incontinence and painful sex, the Mona Lisa Touch is definitely worth investigating. We’ll be talking more with Dr. Dunsmoor-Su in an upcoming podcast, so stay tuned for that. You can also learn more about Dr. Dunsmoor-Su and the Mona Lisa Touch at the Renuvagyn website.

If you’ve received Mona Lisa Touch treatment (or any treatment, really), we’d love to know how it went for you! Send an email to shannon@gennev.com or let us know on Gennev’s Facebook page or in Midlife & Menopause Solutions, Gennev’s closed Facebook group. 

*As always, the information here is just that – information. It’s not intended to replace the expert advice of your doctor, so if you think you need professional help, please go get it.