Menopause Matters: Genitourinary Health and the MonaLisa Touch

In last month’s Menopause Matters column, there was a typo on my part that should have said 30 thousand (not million) women worldwide have undergone MonaLisa Touch.

What is MonaLisa Touch?

MonaLisa Touch was the first FDA approved CO2 laser (2015) specifically designed for use in the vagina. The laser energy stimulates a painless rejuvenation and restoration of genitourinary tissues to their premenopausal state.  The procedure takes 2-3 minutes over 3 treatments 6 weeks apart and one yearly “touch up” treatment.


Who is a candidate for MonaLisa Touch?

More than 50% of postmenopausal women experience vulvovaginal dryness, painful intimacy, and UTI like symptoms which constitute the “Genitourinary Syndrome of Menopause” (GSM). These symptoms are chronic and progressive and do not simply get better with time. In a national survey (The EMPOWER Survey) of ~2000 menopausal women, 90% reported some degree of painful intimacy, and 70% reported bothersome dryness, and 50% of women reported never trying anything to relieve their symptoms. Approximately 7% of symptomatic women actively take hormones for GSM, which means that any untreated symptomatic woman is a candidate for MonaLisa Touch.


What else does the MonaLisa Touch help with?

 MonaLisa Touch can decrease both the number of times a woman gets up at night to urinate (nocturia) and the sudden urge to urinate (overactive bladder).


What is the potential value of MonaLisa Touch compared to standard treatment?

 Standard treatment with estrogen does not help everyone, all the time. In scientific papers looking at patient compliance with estrogen prescriptions, long term use was 17%.  Patients taking systemic estrogen replacement therapy can still have bothersome symptoms about 20% of the time.


Why is MonaLisa Touch not covered by insurance?

 While MonaLisa Touch fractional CO2 laser is approved for use, it is not the first line treatment. Estrogen has been approved for use for over 40 years and is considered the standard of care. There are no procedure codes for MonaLisa Touch and therefore not billable to insurance. Studies are currently comparing MonaLisa Touch to estrogen which may help get insurance coverage.


 If there are different doctors offering MonaLisa Touch, why should I have it done with Dr. Leach?

 I was the first physician in the East Bay to offer MonaLisa Touch and have the most experience in the East Bay. I am the ONLY certified North American Menopause Society practitioner in the East Bay ( and have a nuanced appreciation of how the MonaLisa Touch is one part of improving overall genitourinary health. A $100.00 donation (every new patient) is given to the Cancer Support Community ( in Walnut Creek whose partnership helps breast cancer survivors get the initial treatments for FREE. Donations in 2016 were $6000.00.

Patient testimonials can be seen on my website at Join me for an open house on MonaLisa Touch, Saturday March 25, 10-11 am. Please register by calling (925) 935-6952 or simply drop in.

Dr. Timothy Leach

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