MonaLisa Touch: Purpose, Procedure, Risks and Results
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is MonaLisa Touch?
MonaLisa Touch is a fractional CO2 laser treatment for thinning and dryness of the vaginal lining caused by low estrogen, a condition called genitourinary syndrome of menopause (GSM). Done in a provider's office in about five minutes without anesthesia, it usually takes three sessions six weeks apart and may ease dryness and painful sex. [1]
What the research says
Laser matched vaginal estrogen cream at 6 months in a small trial. Among 62 menopausal women, 85.8% in the laser group rated their symptoms "better or much better," compared with 70% using estrogen cream. The difference was not statistically significant, and no serious side effects occurred. (Paraiso et al., Menopause, 2020) [2]
Laser did not beat a sham (fake) treatment at 12 months. In a double-blind trial of 85 postmenopausal women, real laser and sham treatment led to no significant difference in symptom severity, quality of life or vaginal health scores. (Li et al., JAMA, 2021) [3]
Pooled studies show small, short-term gains. A 2026 review of 36 studies (1,709 participants, including 11 randomized trials) linked laser to better short-term sexual function scores, but the benefit shrank in sham-controlled trials and the certainty of evidence stayed limited. (Zulfikaroglu et al., Int Urogynecol J, 2026) [4]
Key takeaways
MonaLisa Touch targets symptoms of vaginal atrophy, such as dryness, painful sex, irritation and some urinary symptoms. [1]
It is an option for people who can't use estrogen or prefer not to, including some breast cancer survivors. [1]
Each session takes about five minutes, and most people return to normal activities the same day. [1]
A typical course is three sessions about six weeks apart, with touch-ups every 12 to 18 months. [1]
It restores moisture; it does not tighten the vagina. [1]
Study results are mixed, so it helps to discuss the evidence and other treatments with your provider. [2][3][4]
MonaLisa Touch at a glance
Feature | Details |
Type of treatment | Fractional CO2 (carbon dioxide) laser |
Main use | Symptoms of vaginal atrophy (GSM) |
Where it's done | Healthcare provider's office |
Anesthesia | None; numbing cream may be used at the vaginal opening |
Time per session | About 5 minutes |
Starting course | 3 sessions about 6 weeks apart (some people need up to 5) |
Maintenance | Every 12 to 18 months |
Recovery | Same day; avoid sex for 3 days |
Typical side effects | Mild irritation, spotting or discharge for up to 36 hours |
Sources: [1]
What conditions does MonaLisa Touch treat?
MonaLisa Touch treats the symptoms of vaginal atrophy, also called genitourinary syndrome of menopause. [1]
During menopause, estrogen levels fall. This makes the vaginal lining thinner and drier. [1]
That change can cause:
Vaginal discomfort and bleeding
Frequent urinary tract infections (UTIs)
Urinary incontinence, such as leaking urine when you sneeze, laugh or cough
Vaginal irritation, itching or burning
The treatment helps the vaginal tissue regenerate so it can become moist again. [1]
Does MonaLisa Touch tighten the vagina?
MonaLisa Touch does not tighten the vagina. It aims to restore lubrication, not change how the vagina looks or feels in size. [1]
If looseness or sagging is the concern, a provider may suggest other approaches. Our guide to vaginal rejuvenation explains those options and their limits.
Who is a good candidate for MonaLisa Touch treatment?
A good candidate for MonaLisa Touch is someone with symptoms of low estrogen during or after the menopause transition, especially if estrogen therapy isn't an option. [1]
It was developed as an alternative to estrogen-based treatments. That makes it useful for people who can't or prefer not to use hormone therapy for GSM. However, the FDA has not approved or cleared any laser for treating menopause-related vaginal symptoms, and it has warned about reports of vaginal burns, scarring and lasting pain. [1]
May be a good fit | May not be right for you |
Low-estrogen symptoms during or after the transition to menopause | Pregnancy, or giving birth within the last 3 months |
Estrogen therapy tried without success | |
Symptoms after chemotherapy, breast cancer or a hysterectomy | A sexually transmitted infection (STI) or another vaginal infection |
Unable to take estrogen because of other health conditions or treatments | Taking anticoagulants (blood thinners) or having immune thrombocytopenia |
A diagnosed vulvar disorder, such as lichen sclerosus | — |
Sources: [1]
Your provider will review your symptoms and health history to decide whether the treatment suits you. [1]
How does MonaLisa Touch laser therapy work?
MonaLisa Touch works by sending thousands of tiny laser beams into the vaginal tissue, which triggers the lining to repair and rebuild itself. [1]
The device is a fractional CO2 laser. "Fractional" means the energy is split into many small beams that treat tiny spots of tissue rather than the whole surface. [1]
These small, controlled injuries prompt the tissue to:
Grow new blood vessels
Make more collagen
Make more elastin
As a result, the vaginal lining regenerates. [1]
How do you prepare for MonaLisa Touch?
MonaLisa Touch usually needs no special preparation because it involves no surgery and no anesthesia. [1]
Your provider will explain any steps you need before your visit. [1]
What happens during a MonaLisa Touch procedure?
A MonaLisa Touch procedure takes place in your provider's office and feels similar to a Pap smear. [1]
Here's what to expect:
You undress from the waist down and lie back on an exam table.
A sheet covers your legs, and your feet rest in stirrups.
Your provider may apply numbing cream to the vaginal opening.
Your provider inserts a wand-like laser device into the vagina.
The device sends tiny pulses of energy into the tissue.
The provider treats both the inner vaginal wall and the skin at the vaginal opening. The whole treatment takes about five minutes. [1]
Does MonaLisa Touch hurt?
MonaLisa Touch shouldn't hurt, because numbing gel is applied around the vaginal opening before the device goes in. [1]
Some people feel a vibration. Others notice a tiny prick, like the poke of a needle. [1]
How many MonaLisa Touch sessions do you need?
Most people need three MonaLisa Touch sessions spaced about six weeks apart. [1]
Some people need up to five sessions at first. After the starting course, providers often recommend a touch-up every 12 to 18 months, or yearly, to keep symptoms under control. [1]
Many people notice less vaginal dryness after the first session. [1]
What happens after MonaLisa Touch treatment?
Recovery after MonaLisa Touch is quick, and most people return to their usual activities the same day. [1]
Time after treatment | What to expect |
Same day | Back to normal activities |
First 24 to 36 hours | Mild irritation or discomfort |
First 3 days | Avoid sexual intercourse |
If discomfort occurs | Ice packs or a lubricant may help; avoid activities that cause pain |
Sources: [1]
Ask your provider for specific aftercare instructions so you know what to expect. [1]
What are the side effects of MonaLisa Touch?
MonaLisa Touch side effects are usually mild and fade within 36 hours. [1]
The most common ones are:
Irritation at the vaginal opening
Light bleeding
Pink or brown vaginal discharge
Itching or burning when you urinate
Swelling or redness at the vaginal opening
What are the benefits of MonaLisa Touch?
The main benefit of MonaLisa Touch is improved vaginal moisture, which can make sex more comfortable and restore confidence. [1]
It also gives an option to people who can't take estrogen. Before vaginal laser treatment, these patients had few choices for relief, since dryness was traditionally treated with estrogen. [1]
Is MonaLisa Touch effective?
MonaLisa Touch has improved symptoms in many studies, but trials that compared it with a sham treatment found smaller or no clear benefits. [1][3][6]
On the positive side:
On the cautious side:
Type of study | What it found |
Single-group study (102 women) | 84% had significant symptom improvement [5] |
Laser vs estrogen cream (62 women) | Similar improvement at 6 months [2] |
Laser vs sham (85 women) | No significant difference at 12 months [3] |
Pooled sham-controlled trials (7 trials) | No significant difference in symptom scores [6] |
Because results differ, talk with your provider about how the laser compares with other options for your symptoms.
How much does MonaLisa Touch cost?
MonaLisa Touch typically costs $500 to $1,000 per session, and insurance usually doesn't cover it. [1]
Cost factor | What to know |
Price per session | About $500 to $1,000, depending on location and provider |
Insurance | Usually not covered |
Starting course | 3 sessions, though some people need up to 5 |
Touch-ups | Usually every 12 to 18 months |
Sources: [1]
Ask your provider for a full estimate, including follow-up visits, before you start.
When should you call a healthcare provider about vaginal dryness?
You should call a healthcare provider when vaginal dryness or related symptoms make daily life or sex uncomfortable. [1]
A provider can examine you, confirm the cause and talk you through your treatment options, including whether MonaLisa Touch makes sense for you. [1]
Conclusion
MonaLisa Touch is a quick, in-office laser treatment that aims to restore moisture to thin, dry vaginal tissue caused by low estrogen. [1] It needs no anesthesia, has a short recovery and is especially relevant for people who can't use estrogen. [1]
The evidence is still developing. Some studies show clear improvement, while placebo-controlled trials show smaller effects. [2][3][4] The best next step is an honest conversation with your provider about your symptoms, your health history and all your options.
Want to understand the condition behind the symptoms? Read our complete guide to vaginal atrophy (genitourinary syndrome of menopause), then explore more plain-language, evidence-based guides in our health library.
FAQ
Is MonaLisa Touch the same as vaginal tightening?
No. MonaLisa Touch restores vaginal moisture and lubrication; it does not tighten the vagina or change its appearance. Other treatments are used when looseness or sagging is the main concern. [1]
How long does a MonaLisa Touch session take?
A MonaLisa Touch session takes about five minutes and is done in a provider's office. No anesthesia is needed, though numbing gel may be applied at the vaginal opening. [1]
How soon after MonaLisa Touch can you have sex?
You should avoid sexual intercourse for three days after each MonaLisa Touch session. Mild irritation can last 24 to 36 hours. [1]
How long do MonaLisa Touch results last?
MonaLisa Touch results are usually maintained with a touch-up session every 12 to 18 months after the starting course. Many people notice less dryness after the first session. [1]
Does insurance cover MonaLisa Touch?
Insurance usually doesn't cover MonaLisa Touch. Sessions typically cost $500 to $1,000 each, depending on location and provider. [1]
Can breast cancer survivors have MonaLisa Touch?
Breast cancer survivors are among the main candidates for MonaLisa Touch, especially when symptoms follow cancer treatment or estrogen isn't an option. Your care team can help you decide whether it suits you. [1]
Can you have MonaLisa Touch while pregnant?
MonaLisa Touch is not recommended during pregnancy or within three months of giving birth. Active vaginal infections and some bleeding risks can also rule it out. [1]
When should you contact your provider after MonaLisa Touch?
Side effects of MonaLisa Touch usually fade within 36 hours. Contact your provider if symptoms last longer, feel severe or worry you. [1]
Is MonaLisa Touch FDA approved for vaginal dryness?
The laser itself is FDA-cleared for some general medical uses, but the FDA has not approved or cleared any laser to treat menopause-related vaginal symptoms. In 2018 the FDA warned against marketing these devices for vaginal rejuvenation, so ask your provider about the evidence before you decide.
How many MonaLisa Touch sessions do you need?
Most people need three sessions spaced about six weeks apart. Your provider may suggest a later follow-up treatment to help keep the results.
Related Reading
Vaginal Atrophy (Genitourinary Syndrome of Menopause): Symptoms, Causes & Treatment — Complete Guide explains the vaginal and urinary changes low estrogen causes and how they are treated.
Hormone Therapy for Menopause: Benefits, Risks and Types compares menopause hormone therapy options with their benefits and risks.
Painful Intercourse (Dyspareunia): Causes, Diagnosis, and Treatment Explained covers the causes of painful sex and treatments that can help.
Understanding Menopause: Stages, Symptoms, and Management walks through the stages of menopause and ways to manage symptoms.
References
Cleveland Clinic. MonaLisa Touch: Purpose, Procedure, Risks & Results. Cleveland Clinic. Last updated March 2, 2023. https://my.clevelandclinic.org/health/treatments/24779-monalisa-touch
Paraiso MFR, Ferrando CA, Sokol ER, et al. A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial. Menopause. 2020;27(1):50-56. PMID 31574047. https://doi.org/10.1097/GME.0000000000001416
Li FG, Maheux-Lacroix S, Deans R, et al. Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial. JAMA. 2021;326(14):1381-1389. PMID 34636862. https://doi.org/10.1001/jama.2021.14892
Zulfikaroglu E, Zulfikaroglu B. Fractional CO2 Laser for Genitourinary Syndrome of Menopause: Comparator-Aware Systematic Review and Meta-Analysis. Int Urogynecol J. 2026. Epub ahead of print. PMID 42593504. https://doi.org/10.1007/s00192-026-06821-2
Behnia-Willison F, Sarraf S, Miller J, et al. Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause. Eur J Obstet Gynecol Reprod Biol. 2017;213:39-44. PMID 28419911. https://doi.org/10.1016/j.ejogrb.2017.03.036
Ni Y, Lian J. Carbon dioxide laser therapy for the management of genitourinary syndrome of menopause: A meta-analysis of randomized controlled trials. Exp Ther Med. 2024;27(1):10. PMID 38223331. https://doi.org/10.3892/etm.2023.12297
Medical disclaimer
This article is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Always talk with a qualified healthcare provider about your symptoms and before starting or changing any treatment.
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