Start with the simple options
Around menopause, the vaginal walls can thin and make less lubrication. That can bring irritation, itching and discomfort, including during sex. Where low oestrogen is driving the thinning, a doctor can discuss treatment that acts on the lining itself.
We set out the options in a deliberate order. First come products that ease the surface. Next comes a talk with a doctor about prescribed vaginal oestrogen. A device is only discussed after an examination, and only with a clear view of the evidence. Results vary between women, and some women are better served by no device at all.
Non-device options for vaginal dryness after menopause
These improve surface comfort and reduce friction where the lining is dry. They can help mild dryness and discomfort during sex. They do not change the thickness of the lining, and they do not change laxity.
This supports the lining where thinning comes from low oestrogen. It needs a doctor's assessment and a prescription. It does not treat looseness from stretched tissue.
An examination looks for infection, bleeding and other causes that need care before anything else. Your cervical screening history is part of this review.
If you have had cancer treatment
Please involve your oncologist before you decide. Prescribed oestrogen needs that conversation where it is relevant. After some cancer treatments, a woman may still be a candidate for laser, but again only after review with her oncologist where relevant. In 2021 the American College of Obstetricians and Gynecologists looked at urogenital symptoms in women with a history of oestrogen-dependent breast cancer. It stated that laser is neither FDA-approved nor FDA-cleared for symptoms related to menopause. It described the evidence as mostly small observational studies, and said more research is needed before recommending it.
The 2018 FDA caution
In 2018 the US Food and Drug Administration (FDA) issued a warning about energy-based devices marketed for vaginal rejuvenation. It said it had not evaluated these devices for those uses. It reported cases of vaginal burns, scarring, painful intercourse and chronic pain, and it sent notices to seven manufacturers. In the same year, two professional societies, the International Society for the Study of Vulvovaginal Disease (ISSVD) and the International Continence Society (ICS), recommended against using laser and radiofrequency for vulvovaginal atrophy. You should know this before you agree to any device.
What the laser trials found
A trial in JAMA randomised 85 women to fractional CO2 laser or a sham treatment. After 12 months, laser did not significantly improve vaginal symptoms compared with sham.
A review in JAMA Network Open pooled six randomised trials with 270 women. CO2 laser was associated with similar improvement in genitourinary symptoms as vaginal oestrogen, with no significant differences on the main measures.
They answer different questions, and neither settles the matter. Most published studies are small, and sham-controlled trials have given mixed results. You can read more in our guide to the evidence.
Where laser fits, if at all
Our G Lift uses the MonaLisa Touch, a fractional CO2 laser at 10,600 nm with a vaginal probe. It works in a microablative pattern. The stated aim is to support the thickness and moisture of the lining. It does not change lubrication directly. It does not strengthen the pelvic floor or correct prolapse. It may be discussed with women whose dryness or discomfort comes from thinning around menopause, once an examination finds no prolapse, infection or other cause that needs care first. For related symptoms, see our page on vaginal atrophy.
Who should wait or avoid laser
Treatment is postponed in pregnancy. Breastfeeding is discussed first.
This covers active genital or urinary infection, a herpes outbreak, and undiagnosed bleeding.
An abnormal result must be settled first.
Prolapse is assessed and referred to a gynaecologist or urogynaecologist. Pelvic mesh or implants and recent pelvic surgery or radiotherapy are assessed individually.
Risks if you choose laser
Light vibration or warmth can be felt during treatment. Afterwards, mild discharge, spotting, irritation or tenderness can occur. Infection, burn, scarring and painful sex can occur, and true rates are unknown. The FDA has said these devices carry serious risks and lack adequate evidence for this use. The sham-controlled trial by Li and colleagues used MonaLisa Touch, the laser system used for the G Lift. Your dryness may also stay the same. Contact the clinic on the same day for heavy or persistent bleeding, fever, foul discharge, worsening pelvic pain, worsening burning when passing urine, severe pain, new leaking, or a feeling of bulging in the vagina.