MonaLisa Touch Laser Therapy for GSM

As estrogen levels decline, half of all postmenopausal women may experience changes in their gynecologic health that interfere with their personal lives. Women who have survived breast or uterine cancer often go through such changes as well.

Melissa Huggins, MD, and Danielle Staecker, MD, now offer MonaLisa Touch® laser therapy to women in the Kansas City region. It’s an effective, drug-free, outpatient treatment available at our Quivira Specialty Clinic in Overland Park.

The treatment requires no anesthesia, typically taking 3 procedures of 5 minutes each over 18 weeks. The therapy is designed to improve symptoms, often after just a single treatment. And more than 84% of women report significant, lasting improvement.

From surgical procedures that promise to create a younger-looking vagina to minimally invasive therapies that tout increased muscle tightness and tone, the interest in cosmetic procedures below the belt has been booming.

But not all vaginal lasers are developed to appease vanity. Some, such as the MonaLisa Touch laser, were designed for medical, rather than aesthetic, purposes.

"There are many CO2 lasers being used for cosmetic reasons, but they were not designed for specific use on the vaginal skin and tissue," says Dr. Huggins. "The concept for the MonaLisa Touch laser was designed specifically for the vaginal tissue."

In addition to women with lower estrogen levels or estrogen sensitivity, this procedure can treat women who are experiencing the following conditions or symptoms:

According to Dr. Huggins, the MonaLisa Touch laser was developed to treat the symptoms of a condition called genitourinary syndrome of menopause (GSM). This occurs when a woman loses estrogen, whether due to menopause, ovary removal or certain medications, such as drugs used to treat breast cancer. Women with GSM often experience painful intercourse due to thinning of the skin at the vaginal opening (vulva) and decreased lubrication. Additional symptoms include burning and urinary urgency, and lower urinary tract infections.

"It can be physically and emotionally devastating," says Dr. Huggins.

Until now, all of the treatments for GSM were estrogen-based, which created a problem for breast cancer patients. That's because, traditionally, women with breast cancer who take estrogen-blocking drugs couldn't use these estrogen treatments – leaving them with no options for relief. Dr. Huggins says this was a common problem for many of her patients who developed symptoms of GSM after starting breast cancer treatment.

"They'd come to my clinic because of associated incontinence, urinary tract infections and pelvic organ proplapse due to changes in their vaginal skin," Dr. Huggins says. "It was heartbreaking to care for them knowing the treatment for their symptoms was estrogen-based and they couldn't use it."

Estrogen therapy can also be expensive, as insurance companies have slowly stopped covering it. An estrogen cream may cost between $200-$300 per tube, or an average of about $100 per month, Dr. Huggins says. The MonaLisa Touch laser ranges between $600-$1,000 per session, but the results can last a year or longer.

"By the time a patient has used the laser for 2 years, they are already saving money," Dr. Huggins says.

And because FDA approval is currently being sought for treatment for women with painful intercourse, there may come a day when the MonaLisa laser is covered by insurance companies.

The procedure takes place in your doctor’s office and is similar to your annual well woman exam. MonaLisa Touch applies laser energy to the vaginal wall to generate new collagen, elastin and vascularization. It essentially kills scar cells and creates new growth within the tissue.

Benefits of this procedure include:

• Alternative to estrogen therapies
• More than 84% of women report significant improvement
• No anesthesia
• No downtime

A once-a-year single treatment is generally recommended to maintain relief, but your doctor will determine if it’s necessary.

If the thought of having a laser near your vagina sounds unenticing, you aren't alone. But Dr. Huggins says the procedure isn't nearly as bad as it sounds.

Before you begin, a numbing cream is used on the vaginal opening and vulva, where the nerves are more sensitive. Once numb, Dr. Huggins says the procedure is similar to a Pap smear. You recline in a comfortable position on the exam table with your feet in stirrups as the provider inserts a wand-shaped laser into your vagina. Energy pulses are then delivered to specific treatment areas.

"Patients typically report that it feels like a vibration," Dr. Huggins says.

The pulses of energy are calculated to a specific depth and width depending on the area(s) treated. At the health system, both the internal vaginal skin and outer vulva skin are treated to maximize results. The laser energy is then used to create a small, controlled amount of tissue injury. This causes the cells to regenerate and boosts collagen, elastin and blood vessel production. Women who are treated report improved tissue integrity and the return of healthy vaginal skin with better lubrication.

"Researchers are starting to notice that if you don't treat the vaginal opening, the results are not as dramatic," Dr. Huggins says.

Once the procedure is complete, usually in less than 5 minutes, you are free to go back to your normal day-to-day routine. There's no downtime, and the effects are both immediate and long-lasting.

"Many patients experience relief right away," Dr. Huggins says. "But for best results, I recommend an initial series of 3 treatments, 6 weeks apart. Additional single treatments are often performed once yearly on an as-needed basis."

Since The University of Kansas Health System started offering the MonaLisa, many women have benefited from treatment. Dr. Huggins says the MonaLisa treatment has been a game-changer for her patients – especially those going through breast cancer.

"It's very exciting to be able to help a huge population with an innovation that allows them to be treated without the fear of their cancer returning," Dr. Huggins says. "It's life-changing for them."

Improving the quality of life for people with GSM symptoms used to require frequent hormonal medications that provided short-term results. Now, women can benefit from drug-free therapy with long-term improvements.

The MonaLisa laser is used to treat the symptoms of vulvovaginal atrophy – a condition that occurs with declining estrogen levels. Vulvovaginal atrophy causes dryness, burning, painful intercourse and lower urinary tract symptoms, like urgency and infections. Women who are candidates for this procedure include:

• Menopausal or post-menopausal women
• Women who have had their ovaries removed
• Women with breast cancer on estrogen-blocking medications
• Women with hormonal issues, or who are on hormone medications