Vaginal dryness and pain with intercourse is a silent epidemic, affecting millions of women, many of whom are reluctant to discuss their concerns with their healthcare providers. Reasons for not discussing this common problem include embarrassment, cultural taboos, and the belief that there are either no available treatment options, or that hormone treatment is the only option. In addition, healthcare providers may be reluctant to ask about or discuss these issues, often because of a lack of expertise in sexual health.

The drop in estrogen that comes with menopause leads to a series of problems that can severely impact a woman’s social life and personal relationships. One of the most bothersome changes is atrophic vaginitis, also known as vulvovaginal atrophy, or VVA. This condition leads to progressive thinning of the vaginal and vulvar lining, which makes it more delicate, sensitive and more prone to trauma and pain with intercourse.

The technical term for painful sex is “dyspareunia.” Other common symptoms associated with VVA include vaginal and vulvar pain, external and internal irritation, itching and burning. In addition, associated urinary tract symptoms associated with VVA include burning with urination, urinary frequency, incontinence and even recurrent urinary tract infections. These changes in the vaginal and vulvar area can significantly affect a woman’s overall quality of life.

Although there are several different causes of dyspareunia, when this occurs and progressively worsens after menopause, it is often due to VVA. Women enter menopause at an average age of about 52 years and they have a life expectancy of approximately 82 years. That means that a third of her life could be spent in menopause. The declining levels of estrogen significantly alter the lining of the vagina, which can lead to moderate to severe dyspareunia, a symptom of VVA. It is estimated that about 50-60% of postmenopausal women suffer from VVA and pain with intercourse.

Surveys of women have shown that 60% of postmenopausal women between the ages of 57 and 64 are sexually active, and many women remain sexually active for decades after menopause. This is why an effective treatment for moderate to severe dyspareunia could benefit a great number of postmenopausal women.

Improved treatment and screening for breast cancer has resulted in higher survival rates over the past several decades. As a result, there are nearly 3 million breast cancer survivors in the U.S. today. Atrophic vaginitis and VVA is a problem that affects nearly 70% of postmenopausal breast cancer survivors.

If you are suffering from symptoms of VVA, speak with your primary care physician or gynecologist. Vaginal atrophy can be diagnosed with a detailed history and comprehensive physical examination. On pelvic exam, the vagina may appear dry, with pale, frail tissue, and lacking the normal ridges and folds that are present in a healthy vagina. There is often minimal lubrication due to decreased vaginal blood flow and the tissues may be easily traumatized from just the pelvic examination.

In the past, treatment of VVA was limited to hormone therapy, providing estrogen in the form of a pill or vaginal application to reverse the changes associated with menopause. Estrogen preparations can improve dyspareunia, although it may take several months or longer to see benefit from this approach. Many women prefer to avoid estrogen replacement therapy, which has been associated with breast and uterine cancer in some studies. In addition, breast cancer survivors may not be candidates for vaginal estrogen treatment.

MonaLisa Touch is a new treatment that uses laser energy to treat the symptoms you may be experiencing. MonaLisa Touch is a medical laser that delivers controlled energy to the vaginal tissue so cells make more collagen. MonaLisa Touch is now the most effective non-surgical and non-hormonal solution for preventing and treating vaginal atrophy. Recent results from a trial evaluating the laser treatment on postmenopausal women and breast cancer survivors who were experiencing gynecologic health issues showed positive results and a high patient satisfaction rating. MonaLisa Touch is a quick, simple and safe procedure that can be done in your physician’s office, typically by an obstetrician/gynecologist.

The in-office procedure is virtually painless, requires no anesthesia and typically is done under 5 minutes. Patients receive three <5 minute in-office treatments that are spaced six weeks apart. Most MonaLisa Touch patients feel improvement after the very first treatment, although the procedure calls for three treatments. After the third treatment, patients should expect to come back annually for a maintenance treatment. Patients can return to normal activities immediately after the procedure, although they should refrain from sexual activity for 2-3 days. Your doctor can determine a post-procedure regimen that is right for you.

This new laser treatment is available at a MonaLisa Touch Boston, located at One Brookline Place, Suite 301. Call (617) 762-6021 for more information, or to schedule an appointment.

You can here more about the MonaLisa Touch at SHE DID IT/Boston at Babson College on May 17.

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