St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Susan Yarian MD
OB-GYN Associates of St. Augustine 

Effective and Safe Treatment for Vaginal Dryness


June 1, 2017 | View PDF

Great news for women who suffer from chronic irritation of the vagina or vulva! Finally, we have an effective, safe treatment for vaginal dryness. A laser treatment, marketed as the Mona Lisa Touch, has shown excellent results in the over 2500 patients treated world wide.

Menopause brings a welcome end to monthly menstrual cycles, but the low estrogen levels after menopause can also cause thinning of the skin, or mucosa, of the vagina. When estrogen levels are higher, the vaginal tissue is thick, with undulations and infolding. This protects the tissue deep to the vaginal mucosa, which contains nerve endings and blood vessels. If the vaginal skin (or mucosa, in gynecologist terms) has thinned, the nerve endings can be irritated, the small blood vessels can be damaged, thereby causing pain and decreased lubrication.

Some women are menopausal due to surgery, with removal of ovaries. Cancer chemotherapy can induce early menopause, and many of the medications used to prevent recurrence of breast cancer can cause vaginal thinning (atrophy) and dryness. Many patients mourn the loss of a happy sexual relationship, because intercourse is often just too painful to be tolerated, much less enjoyed.

Prior to the introduction of this laser procedure, the only treatment for breast cancer survivors has been water based lubricants. Although these help with dryness, the thin tissue is not affected and sex may continue to be painful. Hormonal treatments are available, but carry some risks; specifically, increased risk of stroke, heart attack and breast cancer.

Other conditions of chronic irritation of the vulvar tissues can be treated with laser as well. The most difficult of these is lichen sclerosis. In this chronic condition, the skin becomes very thin, easily torn, tender, and the patients experience severe itching. This is also an effect of the lack of thick skin protecting the sensitive nerves below. Laser treatments to the vulva have shown a great reduction in symptoms.

The procedure involves three to five treatments, 6 weeks apart. Risks are minimal, including only risks of any laser procedure. Pain during the procedure is minor, and numbing creams can be used if needed. Unfortunately, no insurance plans cover this procedure at this time.

We have this in our office.

Susan Yarian, MD

Dr. Yarian is a graduate of the University of Florida, with a BS in Industrial Engineering. She worked as an engineer for years before pursuing her medical degree at the University of South Carolina. As the founding partner of ObGyn Associates of St Augustine, she has been gratified to watch the practice grow from a one doctor, one midwife office in 2001 to our current practice. She is particularly interested in high-risk obstetrics, but enjoys all aspects of gynecology care. Even after 21 years in private practice, she feels it is a privilege to be a part of women's lives in such an important way.


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