ASSERT NSW hosted a very successful Education Night recently when Sydney gynecologist, Dr. Yasmin Tan, came to talk to us about an exciting new technology which is used to treat vaginal atrophy, a condition that plays havoc with the sex lives of many women

Dr. Tan told us that up to 50% of women in their midlife and later, are troubled by the symptoms of vaginal atrophy. “The toll on the sex lives of these women is enormous, yet there is a general lack of communication regarding female sexual health issues in the clinical setting”.

She says the condition is significantly under-diagnosed with a 2013 survey of post-menopausal women reporting that only 19% of health care professionals addressed patient’s sex lives (REVIVE – Real Women’s Views of Treatment Options for Menopausal Vaginal Changes) and only 13% specifically raised the issue of genitourinary symptoms.

Vaginal atrophy most often develops after menopause but can occur during breast-feeding or at any other time when the body’s estrogen levels drop, such as after cancer treatment. When this happens there are fewer epithelial cells exfoliating into the vagina and there is a loss of lactobacilli, which leads to less lactic acid and results in a higher PH in the vagina. This allows for the overgrowth of other bacteria causing an increase in vaginal infections and inflammation. Overall the vagina has less elasticity, connective tissue increases, blood flow is reduced and the chance of infections and inflammation is increased.

Symptoms include: vaginal dryness, burning and discharge, genital itching, bleeding after sex, discomfort or pain during sex, burning with urination, and increase in urinary tract infections, urinary incontinence, or urgency, decreased vaginal lubrication and shortening and tightening of the vaginal canal.

Clearly these symptoms can take a great toll both on the individual and on sexual relationships. Physical changes include atrophy of the clitoris, tearing or trauma, infection, pain and bleeding. These in turn can lead to vulval pain disorders, decreased sexual arousal and avoidance of sex.

Up until recently treatments have focused on either using lubricants and long-lasting moisturizers or hormonal treatments including low-dose vaginal estrogens. Today, however, there is a third option – called The Mona Lisa Touch – an Italian built fractional CO2 laser system, which rejuvenates connective tissue and epithelium of mucosa in the vagina.

The procedure encourages new collagen fibers, helps with water retention and improves blood supply. It has also been found to improve lactobacilli levels and Dr. Tan says the treatment returns tissues to the pre-menopausal conditions “firm, hydrated and better lubricated.”

Dr. Tan explains that the CO2 ray generates heat that vaporizes the water content of target cells. The laser penetrates the tissue and releases heat which causes rapid ablation (scaring or destroying tissue) of the epithelium.

The procedure takes only 5 minutes and is “relatively painless” with the most discomfort being associated with the insertion of the probe. There are three treatments approximately a month apart with top-ups recommended only when necessary. Recovery time is round 48 hours and five days before sex is resumed. Dr. Tan says there are no adverse effects reported as yet, although there are only a handful of studies on the use and effectiveness of the technology.

To see how it works, please check out the video

“The science behind the therapy is still very new and it will take time for comprehensive studies to be done. However, what data does exist indicates a ‘significant improvement in vaginal atrophy symptoms’ and overall 91.7% of patients treated were satisfied or very satisfied with the results”.

Dr. Tan says the technology is still in its infancy, but so far the CO2 laser seems to be a “safe, effective and feasible option”. She has been using it successfully now with an increasing numbers of women who report that the treatment restores vaginal tissue leaving it “firm, hydrated, and better lubricated”.

Anyone wanting more information should go to Dr. Tan’s website