What Is MonaLisa Touch?

MonaLisa Touch is a medical-grade CO2 fractional laser system developed by DEKA, an Italian company with more than 40 years of experience in laser technology. The treatment uses precisely controlled CO2 laser energy delivered through a purpose-designed intravaginal probe to create microscopic channels in vaginal tissue — a process known as fractional photothermolysis.

These micro-injuries stimulate the body's natural healing cascade, triggering the production of new collagen, elastin, and hyaluronic acid within the vaginal mucosa. As collagen remodels and moisture-retaining glycogen levels are restored, the vaginal epithelium thickens, becomes more elastic, and re-establishes its natural lubrication. The result is tissue that more closely resembles its pre-menopausal state — structurally, functionally, and physiologically.

What distinguishes MonaLisa Touch from older ablative lasers is its fractional delivery pattern and the DEKA D-Pulse technology, which controls energy distribution to maximise regeneration while minimising thermal damage to surrounding tissue. This makes it safe enough to perform without anaesthesia and gentle enough to require no recovery period.

Conditions Treated with MonaLisa Touch

MonaLisa Touch was originally developed to address Genitourinary Syndrome of Menopause (GSM) — a cluster of symptoms caused by declining oestrogen levels that affect the vulva, vagina, urethra, and bladder. At THE FIT CLINIC Bangkok, our urogynecology and aesthetic gynecology specialists use it to treat a broad range of related conditions:

• Vaginal dryness and atrophy: Thinning, dryness, and fragility of vaginal tissue most commonly seen in peri- and post-menopausal women, and in breast cancer survivors on anti-hormonal therapy.
• Genitourinary Syndrome of Menopause (GSM): The full spectrum of urogenital symptoms linked to oestrogen deficiency, including itching, burning, discharge changes, and urinary urgency.
• Dyspareunia (painful intercourse): Pain or discomfort during sexual activity caused by vaginal dryness and loss of tissue elasticity.
• Post-partum vaginal laxity: Mild changes in vaginal tone following childbirth that affect comfort and sensation.

MonaLisa Touch is a non-hormonal option that is sometimes considered for women who cannot use, or prefer not to use, systemic or topical hormonal therapy. Whether it is appropriate for you is decided at an assessment with the doctor.

What It Is Not For

This matters more than the list above, because these problems arrive together around menopause and are routinely mistaken for one another.

• Urinary incontinence. Laser is not a first-line treatment for leaking, and we do not offer it as one. If urine escapes when you cough, sneeze, laugh or lift, the appointment that helps is a pelvic floor assessment. Depending on what that finds, the options are supervised pelvic floor training taught properly, electromagnetic stimulation of the pelvic floor, a pessary, or surgery — a different conversation entirely.
• Pelvic organ prolapse. A sensation of heaviness, dragging, or something coming down is a structural problem. A laser does not lift a prolapse. It needs examining and staging, and our urogynecologists assess and treat it directly.
• Pain from a tight pelvic floor. Painful sex is not always dryness. An overactive, guarded pelvic floor causes the same complaint and is made no better — sometimes worse — by treating it as an atrophy problem.
• Undiagnosed bleeding, discharge or a skin condition. Post-menopausal bleeding, a persistent discharge, or vulval itching and whitening that could be lichen sclerosus each need a diagnosis first. Treating the surface before the cause is known is how a diagnosis gets delayed.

Try This First

For vaginal dryness and atrophy, two things are established first-line and should be discussed before any laser is booked. A vaginal moisturiser used on a regular schedule — not only before sex, which is what a lubricant is for — and low-dose local oestrogen, which acts on the vaginal tissue itself. Many women do well on those alone and need nothing further. If you have had breast cancer, local oestrogen is a decision to make jointly with your oncologist, and it is one of the situations where a non-hormonal option is reasonably raised.

Laser is considered when first-line measures have been tried and have not been enough, or when they are not an option for you. That sequence is the honest one, and it is the one we follow.

The Procedure: What to Expect

Your MonaLisa Touch journey at THE FIT CLINIC begins with a detailed consultation with one of our specialists — Assoc. Prof. Dr. Orawee Chinthakanan, Dr. Athasit Kijimanawat, or Dr. Apichaya Klaikaew — who will review your symptoms, medical history, and suitability for the treatment.

Each treatment session itself takes approximately 5 minutes. The DEKA probe is gently introduced into the vaginal canal and slowly withdrawn while emitting controlled fractional CO2 pulses along the vaginal wall. No anaesthesia or numbing cream is used. Women commonly describe the sensation as a mild vibration or warmth; some find it more noticeable than that, and you can ask the doctor to stop at any point.

The usual protocol is three sessions spaced 4–6 weeks apart, because that interval allows the tissue to complete a collagen-remodelling cycle before the next stimulation. That is a protocol, not a prediction — how you respond is individual, and whether you continue is reviewed as you go rather than committed to in advance. We do not sell fixed session packages.

No recovery period is needed. You may have very mild spotting or a slight watery discharge for 24–48 hours, and normal daily activities including work can be resumed straight away. We recommend avoiding sexual intercourse for 3–5 days afterwards.

Clinical Evidence & Safety Profile

Vaginal laser is among the more studied energy-based treatments in this area, and the published picture is genuinely mixed — which is worth saying plainly rather than leaving you to discover it. Observational studies and several randomised trials report improvement in dryness, burning, itching and discomfort during intercourse, alongside tissue-level findings of increased collagen density and thicker epithelium. Other randomised, sham-controlled trials have found no meaningful difference between laser and a sham procedure. Professional bodies including ACOG have cautioned against marketing vaginal laser as an established treatment on the strength of the weaker studies.

What that means in practice: this is a reasonable option to discuss for dryness and atrophy when first-line measures have not been enough, and it is not a settled answer. Anyone who tells you the evidence is unambiguous is overselling it. We would rather you booked knowing that.

At THE FIT CLINIC Bangkok, MonaLisa Touch is performed only by qualified urogynecology and aesthetic gynecology doctors — not by nurses or technicians.

Frequently Asked Questions

What does MonaLisa Touch treat, and what does it not treat?

It is used for vaginal dryness and atrophy, including the genitourinary syndrome of menopause, and for discomfort during intercourse that comes from dry, thinned tissue. It is not a first-line treatment for urinary incontinence, and it is not a treatment for pelvic organ prolapse. If leaking is your main symptom, the useful appointment is a pelvic floor assessment, not a laser consultation — those are different problems that happen to appear together around menopause.

Should I try anything before considering laser?

Yes, and this should be part of the conversation rather than a step you find out about afterwards. A vaginal moisturiser used regularly, not only before sex, and low-dose local oestrogen are the established first-line options for vaginal dryness and atrophy. Many women do well on those alone. Laser is considered in selected cases after assessment, and after a discussion of the evidence, the alternatives and the limitations.

What happens at the first visit?

A consultation with a doctor: your symptoms, menopausal and hormonal status, medical history, current medications, and an examination to distinguish dryness and atrophy from a tight pelvic floor, a weak pelvic floor, prolapse, infection or a skin condition such as lichen sclerosus. These feel similar and are managed differently. The consultation fee is ฿1,500–3,000 depending on the complexity of the case, plus a ฿300 clinic service fee. You are not committed to a treatment by attending.

What is a MonaLisa Touch session actually like?

The session itself takes about five minutes. A purpose-designed probe is introduced into the vaginal canal and slowly withdrawn while the DEKA CO2 laser delivers fractional pulses along the vaginal wall. No anaesthesia or numbing cream is used. Women commonly describe a mild vibration or warmth; some find it more noticeable than that, and you can ask the doctor to stop at any point. Light spotting or a watery discharge for a day or two is usual. We advise avoiding intercourse for three to five days afterwards.

How many sessions, and how far apart?

The usual protocol is three sessions spaced four to six weeks apart, because that interval allows the tissue to complete a collagen-remodelling cycle before the next one. That is a protocol, not a promise: how you respond is individual, whether you continue is reviewed as you go, and we do not sell fixed session packages in advance. For current pricing, contact us via LINE at @thefitbkk or call +66 92 294 6555.

Who should not have MonaLisa Touch?

It is not appropriate during pregnancy, with an active vaginal or pelvic infection, or with undiagnosed vaginal bleeding, which needs investigating on its own account first. If you have had breast cancer, laser is often raised as a non-hormonal option, but the decision belongs in a conversation with your oncologist as well as with us. Prolapse, a painful tight pelvic floor, and skin conditions such as lichen sclerosus need their own diagnosis before any laser is discussed.