The Pelvic Health Problems Women Don't Talk About (And the Solutions That Actually Work)
If you watch Friends & Neighbors , you may have caught the scene: a group of women in a sauna, having the kind of honest conversation most women only have in their own heads — and one of them brings up Mona Lisa Touch. Out loud. In a hit show.
I nearly cheered. Because in twenty years of practice, the thing I've watched women suffer through in near-total silence is exactly this: the vaginal changes of menopause. Dryness. Pain with intimacy. A sense that this part of their life is simply over.
It is not over. And it is not something you have to quietly endure.
Vaginal Atrophy Is Common, Normal — and Treatable
Let's name what's actually happening, because so many women think something is wrong with them specifically.
As you move through perimenopause and menopause, estrogen, progesterone, and testosterone all decline. Estrogen in particular keeps the vaginal wall thick, elastic, and naturally lubricated. As it drops, that tissue becomes thinner, drier, and less elastic — a condition called vaginal atrophy, now often called genitourinary syndrome of menopause.
The symptoms are real and they're physical: Pain or discomfort with intercourse. Persistent dryness. Decreased libido. Even more frequent urinary tract infections.
Here's what I need you to hear: this is normal physiology, not a personal failing — and "normal" does not mean "untreatable." Every woman goes through some version of this. Almost none of them were told they had options. You have options.
What Mona Lisa Touch Actually Is
Mona Lisa Touch is a CO2 laser treatment that has been around for two to three decades. It works by delivering targeted, gentle laser energy to the tissue inside the vagina — which stimulates the body's own collagen and elastin production and increases blood flow to the area.
The result is tissue that becomes healthier, thicker, and more functional again. Not masked. Actually restored.
And let me be very clear about what this is not. This is not cosmetic. This is not "vaginal rejuvenation." This is the treatment of real, clinical, medical symptoms — dryness, pain, discomfort — that affect a woman's comfort, her intimacy, and her quality of life. Treating that is medicine, full stop.
It's particularly meaningful for one group of women who are too often left with nothing: breast cancer survivors who can't take estrogen. For them, an effective non-hormonal option isn't a luxury. It's a lifeline back to comfort.
Is It Painful? What Treatment Actually Looks Like
This is the first question every patient asks, so let me answer it honestly.
The procedure itself is fast, and shockingly painless. The longest part is the numbing — we apply topical lidocaine to the outside and inside, which takes about twenty minutes. After that, the treatment itself is quick and comfortable. As the numbing wears off, some women feel a bit of warmth, almost like a mild sunburn, and within a few days everything feels completely normal.
For a full result, we do a series of three treatments spaced about six weeks apart, followed by annual maintenance to keep the benefits going. Some patients — certain cancer survivors, for example — do best with a more customized, frequent schedule.
What women describe afterward is consistent: less dryness, less pain, more comfort, and something harder to measure but just as real — feeling like themselves again. It isn't an instant switch. Over the series, the change can be genuinely transformative.
What I See in Practice
Mona Lisa Touch was the very first laser I purchased when I founded Kind Health Group. I've done thousands of these treatments since, and it remains one of my favorite things I do — because of the faces. Women walk in resigned, certain this part of their life is finished, and walk out of the series with their comfort and their confidence back.
That's the whole reason I built this practice: to treat the things other doctors rush past or never mention. Vaginal health after menopause is not a footnote. It's your comfort, your intimacy, and your quality of life — and it deserves real medicine.
What You Can Do Right Now
If intimacy has become painful, or dryness is affecting your daily comfort, stop treating it as something you're supposed to accept. It's a treatable medical condition. Bring it up with your physician — plainly, without embarrassment — and ask about your full range of options, which may include systemic estrogen, vaginal estrogen, or laser therapy like Mona Lisa Touch, depending on your health history.
And if hormones aren't right for you — particularly if you're a breast cancer survivor — know that effective non-hormonal options exist. You are not out of choices.
If you're in North County San Diego — Encinitas, Del Mar, Carlsbad, Rancho Santa Fe — this is exactly the care we provide at Kind Health Group, and Mona Lisa Touch has been part of my practice since day one. Comfort and intimacy don't have to end with menopause.
Frequently Asked Questions
What is Mona Lisa Touch?
It's a CO2 laser treatment for the vaginal changes of menopause. It delivers targeted laser energy to the vaginal tissue to stimulate the body's own collagen and elastin production and improve blood flow, which restores healthier, thicker, more comfortable tissue. It treats real medical symptoms like dryness and painful intercourse — it is not a cosmetic procedure.
Is Mona Lisa Touch painful?
For most women, no. The longest part is numbing with topical lidocaine (about twenty minutes); the treatment itself is fast and shockingly comfortable. Afterward you may feel mild warmth, like a light sunburn, that resolves within a few days.
How many treatments will I need?
A typical course is three treatments spaced about six weeks apart, followed by annual maintenance to sustain the results. Some patients, including certain cancer survivors, benefit from a more customized schedule. Improvement builds over the series rather than happening instantly.
Can I have it if I can't take estrogen?
Yes — that's one of its most important uses. Because it's a non-hormonal treatment, Mona Lisa Touch is especially valuable for breast cancer survivors and others who can't or prefer not to use estrogen but are struggling with dryness and painful intercourse.
What symptoms does it help with?
Vaginal dryness, pain or discomfort with intercourse, decreased comfort, and related quality-of-life symptoms of menopause and perimenopause. If you're experiencing these, it's worth a conversation with your physician about whether it's right for you alongside your other options.
This post grew out of a candid "asking for a friend" episode of The Kind Revolution Podcast, where Dr. Nanos and KHG's Lauren Luscombe Holder tackle the women's-health topics nobody talks about openly enough:
The Kind Revolution Podcast — the women's-health conversations we should be having out loud — including why menopause doesn't have to mean the end of comfort and intimacy.
Also available on Apple Podcasts, Spotify, Amazon Music, and YouTube. Search "The Kind Revolution."
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