Understanding MonaLisa Touch: A Non-Hormonal Option for Symptoms of Menopause

For many women, certain changes that come with menopause are talked about openly hot flashes, sleep disruption, mood shifts. Other changes are rarely discussed, even with a physician. Vaginal dryness, discomfort during intimacy, recurrent urinary symptoms, and a general loss of comfort in everyday activities are among the most common.

These symptoms have a name: Genitourinary Syndrome of Menopause (GSM). While the conversation around it is often quiet, the experience is not uncommon. Research suggests that GSM affects somewhere between 27% and 84% of postmenopausal women, with higher rates among women who have undergone treatment for breast cancer.

If you’ve found yourself wondering whether what you’re experiencing is “just part of getting older,” this post is intended to offer some clarity and to introduce one of the treatment options available: MonaLisa Touch.

What Is GSM and Why Does It Happen?

As estrogen levels decline during and after menopause, the tissues of the vulva, vagina, and lower urinary tract gradually change. The vaginal lining becomes thinner, less elastic, and produces less natural lubrication. Blood flow to the area decreases, and the local environment — including the balance of healthy bacteria — shifts as well.

Over time, this can lead to:

Vaginal dryness, burning, or itching
Discomfort or pain during intercourse
Increased frequency of urinary tract infections
Urinary urgency or mild incontinence
A general sense of tissue fragility or sensitivity

These changes are physiological, not psychological and they are also progressive if left unaddressed. The good news is that several treatment paths exist, and the right one depends on the patient.

Where MonaLisa Touch Fits In

MonaLisa Touch is a fractional CO2 laser treatment designed specifically for the vaginal tissue. It is performed in-office, generally takes about five minutes per session, and does not require anesthesia or downtime.

The standard protocol is three treatments, spaced approximately six weeks apart, with periodic maintenance sessions afterward depending on individual response.

How It Works

The treatment delivers controlled laser energy in a fractional pattern. This means energy is distributed in microscopic columns, leaving the surrounding tissue intact. This pattern is what allows the body to heal quickly while still receiving a meaningful regenerative signal.

The laser energy is absorbed by water within the tissue, which generates gentle, targeted heat in the submucosal layer. This stimulates the body’s own repair processes specifically, the activity of fibroblasts, the cells responsible for producing new collagen and elastin.

Histological studies — meaning studies that examine actual tissue samples under a microscope — have observed that following treatment, vaginal tissue tends to show:

Thicker, more organized epithelium
Increased collagen and elastin
Improved vascularization (blood flow)
Restoration of glycogen, which supports a healthy vaginal microbiome

The treatment is not designed to mask symptoms, instead it works by encouraging the tissue itself to behave more like it did at an earlier stage of life.

What the Research Says

Clinical evidence for fractional CO2 laser treatment of GSM has grown considerably over the past decade, including a randomized clinical trial (the VeLVET trial) comparing laser therapy with vaginal estrogen.

Across published studies, outcomes have generally been favorable for symptoms such as dryness, burning, and discomfort during intercourse. Patient-reported satisfaction in many studies falls in the range of 80% or higher and improvements in tissue health have been documented both clinically and histologically.

That said, it’s important to be measured about the evidence:

Individual responses vary and not every patient experiences the same degree of improvement.
The duration of benefit is not unlimited — collagen remodeling slows over time and many patients benefit from periodic maintenance treatments.
Major medical organizations continue to study long-term outcomes, and the treatment is best understood as one tool among several, not a universal solution.

A thorough consultation is the only way to determine whether MonaLisa Touch is appropriate for a given patient.

A Note for Breast Cancer Survivors

For women who have been treated for breast cancer, GSM is particularly common. Estimates suggest that up to 70% of breast cancer survivors experience symptoms — often beginning earlier and more abruptly than in the general menopausal population, due to the effects of chemotherapy, ovarian suppression, or aromatase inhibitors.

For these patients, vaginal estrogen — the most established medical treatment for GSM — is often not recommended, or is approached with significant caution by their oncology team.

Because MonaLisa Touch is non-hormonal, it has been studied as a possible option in this population. It is not a replacement for ongoing oncology care and any decision should be made in coordination with the patient’s oncologist. But for women who have felt that their options were limited, it can be worth a conversation.

What to Expect at a Visit

The treatment itself is brief and generally well tolerated. Most patients describe the sensation as a mild vibration or warmth rather than pain. There is no required preparation beyond a standard gynecologic consultation and most patients return to normal activity the same day, with a short period of pelvic rest afterward.

Improvement is typically gradual. Some patients notice changes within a few weeks of the first treatment; others find that the most meaningful improvement comes after the full series is complete.

Is This Right for You?

If you’ve been experiencing symptoms that affect your comfort, your intimacy, or simply your sense of well-being — and especially if you’ve found existing treatments insufficient or unsuitable — it may be worth a conversation.

The most important step is not choosing a treatment. It’s having an honest discussion with a provider who understands GSM, takes your symptoms seriously, and can walk you through every option available — including, in some cases, deciding that a different approach is the better fit.

If you’d like to schedule an office visit to discuss whether MonaLisa Touch might be appropriate for you, we’d be glad to help. Just click the “schedule now” button at the top of the page.

Sources:

StatPearls. Genitourinary Syndrome of Menopause. NCBI Bookshelf, updated 2024. https://www.ncbi.nlm.nih.gov/books/NBK559297/

Paraiso MFR, Ferrando CA, Sokol ER, Rardin CR, Matthews CA, Karram MM, Iglesia CB. A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial. Menopause. 2020 Jan;27(1):50-56. https://pubmed.ncbi.nlm.nih.gov/33179118/

Mayo Clinic News Network. Breast cancer survivors find relief for debilitating menopause symptom. 2025. https://newsnetwork.mayoclinic.org/discussion/breast-cancer-survivors-find-relief-for-debilitating-menopause-symptom/

Reviewed by the clinical team at North Florida Women’s Care to ensure accuracy and alignment with current medical guidelines.