Ask the Nurse

I’m interested in Mona Lisa on laser rejuvenation procedures. Also, as a practitioner, I’m curious about recent research on testosterone pellets for post-menopausal women.


The Mona Lisa laser works by stimulating collagen production in the vaginal tissue, thereby potentially helping symptoms associated with vaginal atrophy. It is ablative causing microinjury to the lining of the vagina. While there is benefit to restoring collagen to the tissue, these procedures are often costly and NOT supported by large clinical data.

There is also a radiofrequency vagina heat probe (with cooling tip to protect the superficial lining of the vagina) called Vivene that stimulates collagen formation in the vagina and there is a similar probe called ThermaVi without the cooling tip. The best way to treat atrophy is by replacement with vaginal estrogen or a newer therapy called intravaginal DHEA, which is a nightly suppository of DHEA that’s a precursor hormone to estrogen and testosterone. When applied nightly it allows your body to make its own estrogen and testosterone, which not only helps with atrophy but also sexual function.

There are also non-estrogen oral therapies like Osphena which are FDA approved to treat vulvovaginal atrophy/genital syndrome of menopause. Testosterone pellets are NOT FDA approved in women and can be associated with tachyphylaxis (tolerance). It is important to seek out a menopause expert and not those practitioners looking to enrich themselves by offering experimental therapies.

All My Best,
Speaking of Women’s Health Nurse

April 10, 2018 at 1:28pm