Suddenly, after years of discomfort, they are having great sex again.
From Beverly Hills to Newport Beach, they’re whispering about how just a few zapping sessions of so-called “vaginal revitalization” have reversed the dryness down there.
“They come to me knowing exactly what they want,” says Dr. Tristan Beekman, who has been offering the treatment for several years in her Santa Monica practice.
Thin detectors, such as Mona Lisa Touch, FemiLiftGeneveve, Votiva and ThermiVa, cause controlled injury to the tissues of the vaginal walls using laser or radio frequency energy, supposedly increasing collagen production and blood flow to the area. That’s the working theory, at least. Not everyone is convinced.
Despite growing concerns about the effectiveness — and safety — of these emerging, expensive treatments, patients are willing to take the risk because it seems like a quick fix to a problem underserved by imperfect solutions. Many patients have suffered injuries, including vaginal burns, scarring and ongoing pain, according to the Food and Drug Administration has warned.
And yet a Los Angeles urologist assures women that ThermiVa can help them “safely and effectively reclaim their feminine wellness.” A gynecologist in Northern California says the MonaLisa Touch can “relieve painful intercourse, reduce urinary urgency, restore your satisfaction and revitalize your relationship.” and an Orange County dermatologist promises that 30 minutes with Geneveve will “change his life and yourself.”
Dr. Margaret Bates, a gynecologist in Los Angeles, does not use these energy-based machines in her practice, but refers patients to other providers when she feels it is necessary. Like Bickman, she has seen positive results. “The MonaLisa procedure has been transformative for several of my patients,” says Bates. “It allowed them to gain a few extra years of comfortable sexual activity.”
What is “vaginal resuscitation”?
Vaginal rejuvenation is a broad term used to describe both surgical and non-surgical procedures that help turn back the clock. As women enter menopause, declining estrogen levels cause the vaginal lining to become drier and thinner. For many, these changes trigger a range of genital and urinary symptoms, including dryness, burning and irritation of the vagina or vulva, frequent and urgent urination, and painful intercourse.
Intercourse often becomes uncomfortable, if not downright painful, and is driven by the university investigations of postmenopausal women Show that this discomfort makes sex less enjoyable or causes them to avoid sexual intimacy altogether.
Women often suffer in silence. In a research of those with vaginal symptoms, about half had discussed them with their health care provider. Some are too embarrassed to report them, while others see no point in reporting a sensitive problem because they believe there is no effective way to deal with it.
The technology behind vaginal resuscitation devices is nothing new. In fact, it has been used successfully for years in many areas of medicine. Gynecologists use it to destroy precancerous lesions on the cervix, and dermatologists use it to remove tattoos, fade sunspots, and get rid of wrinkles. Since the FDA approved these devices for certain treatments, doctors are allowed to use them for others as they see fit, including vaginal resuscitation.
High demand despite risks
However, the FDA and professional industry groups, such as the North American Menopause Society and the American College of Obstetrics and Gynecology, warn that the treatment’s effectiveness has not been properly evaluated. Many of the effectiveness studies fail to account for a possible placebo effect, critics say.
“The laser market got so big so quickly but without much evidence. We were just trying to figure out if it was effective or not,” says Dr. Fiona Lee, a gynecologist at the Royal Women’s Hospital in Sydney, Australia, and the lead author of a study, published last year in the Journal of the American Medical Assn., that tested the technology against a placebo.
The trial included 85 postmenopausal women with vaginal symptoms. About half received full vaginal laser treatment, while the rest received “sham” treatment (the laser rod was placed in their vagina and the machine turned on, but at a minimal energy setting). Twelve months after treatment, the researchers found that there were few evident differences between the two groups of women. Women in both groups showed similar improvement in their overall symptoms as well as the severity of their symptoms. they also reported similar rates of sexual activity and sex quality.
“Although we saw some improvement, it was the same in both groups,” says Li. “I don’t think it was the energy itself.”
The research team also compared vaginal wall biopsies taken one month before treatment with those taken two to three months after. Again, they found no significant differences between the two groups.
In response to these results, Dr. Marisa Adelman and Drs. Ingrid Nygaard, professor of obstetrics and gynecology at the University of Utah School of Medicine, recommended in JAMA that the widespread, largely unrestricted use of vaginal laser therapy to treat genital symptoms should be discontinued. “There are two main concerns,” says Adelman. “We don’t know if it’s effective and we don’t know if it’s safe.”
“Gynecologists would like better treatments. But we want them to be affordable and effective,” adds Adelman. The initial course of three treatments with the MonaLisa Touch typically costs $2,700 to $3,000, with contact sessions costing extra, while three sessions with the Votiva device can cost upwards of $3,500. These treatments are not covered by insurance.
For now, Adelman believes the use of vaginal lasers should be limited to clinical studies. But this is unlikely to happen. There are simply too many doctors who have purchased energy-based devices for their practices and too many patients who are interested in pursuing this type of treatment.
“We need to stop advertising these treatments that cost women a lot of money,” says Li. “If it doesn’t work, why put yourself through the cost and potential harm?”
Cheaper alternatives aren’t perfect
There are lower-cost alternatives — albeit imperfect ones. “For women with mild symptoms, the standard approach is to start with moisturizers and lubricants,” says Dr. Sharon Winer, clinical professor of obstetrics and gynecology at USC’s Keck School of Medicine. While they won’t reverse the physical changes underlying the symptoms, moisturizers and lubricants can combat vaginal dryness and improve the experience of penetrative sex.
“From there you can move on to hormone products, most of which are estrogen,” says Winer. Estrogen, applied directly to the inside of the vagina in the form of creams, tablets, or rings, can relieve many age-related symptoms, including painful intercourse. Although some women are concerned about vaginal estrogen because of the well-established link between oral estrogen and cancer, blood clots, and strokes, when applied topically, estrogen has been found be safe for most women.
However, women looking for zap-and-go treatments don’t want to use vaginal products that require constant use and stop working if discontinued.
“They want a quick fix,” says Winer.
