MonaLisa Touch vs. ThermiVA

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Dec 10

Karny Jacoby FPMRS

MonaLisa Touch vs. ThermiVA

by Karny Jacoby FPMRS

New innovative treatments for age related vaginal changes including dryness and pain during intimacy are becoming increasingly popular. With so many options available the question is “what is the difference?” Specifically, what is the difference between ThermiVA and the MonaLisa TouchTM?


ThermiVA and MonaLisa TouchTM are the more common treatments used to treat atrophic vaginitis, vaginal dryness and pain during sex. Both are non-surgical procedures available as an in-office treatment designed and approved to treat a very specific condition typically caused by menopause, aging, child birth and breast cancer survival. These conditions include:

- Dryness

- Pain during intimacy

- Urinary incontinence

However, ThermiVA and the MonaLisa TouchTM are different. Each are promoted to achieve similar results for resolving the symptoms of menopause, vaginal dryness and painful intercourse.

The biggest difference between them is the type of energy used to increase blood flow and promote collagen growth. ThermiVA is a radio frequency device that uses heat to achieve desired outcomes; whereas, the MonaLisa TouchTM uses laser energy to administer heat to penetrate vaginal tissue.

The MonaLisa TouchTM CO2 laser is a fractional ablation device that uses DOT Therapy to apply laser energy to the vaginal walls in a non-continuous mode. With the fractionated laser only, a small percentage of tissue is effected resulting in stimulation, regrowth and thickening while avoiding pain and side effects both during and after the treatment.  The dual-action of the MonaLisa TouchTM, both heat and fractional ablation, promotes blood flow and collagen growth. In contrast, the ThermiVA ONLY uses heat.

  • ThermiVA = Radio Frequency = heat
  • MonaLisa TouchTM = Laser = heat + fractional ablation

Is treatment using the MonaLisa Touch or ThermiVA painful?

ThermiVA has been described as having less downtime and less pain than MonaLisa TouchTM by the professionals that offer this treatment. ThermiVA’s claims that it is less painful are unsupported.

The MonaLisa TouchTM is performed in a physician’s office, requires no anesthesia or down time, with treatments lasting less than 5 minutes and is reported as being mildly uncomfortable. Patients are able to return to normal activity immediately following treatment. For optimal results patients are advised to refrain from intercourse for the first 24 hours.

How much does the MonaLisa TouchTM and ThermiVA cost?

According to reviews on REALSelf, the cost of ThermiVA ranges from $2,500 - $3,500 for 3 treatments while the average cost reported for the MonaLisa TouchTM ranges from $1,800 - $3,000 for 3 treatments.  More Frequently Asked Questions about the MonaLisa TouchTM.

How long do results last using the MonaLisa TouchTM laser vs. ThermiVA?attractive_mature_couple_monalisa_touch.jpg

ThermiVA reports that maintenance treatments are needed between 8 – 12 months versus the MonaLisa Touch’s 12 months. The dual-action of the fractional CO2 laser, heat and fractional ablation, should have a longer lasting effect. Neither are permanent as our bodies continuously age and skin cells including the vagina are damaged.

Does the MonaLisa TouchTM or ThermiVA improve or resolve stress incontinence?

Patients from both ThermiVA and MonaLisa TouchTM have reported improvement or resolution to stress incontinence and urinary problems, but there are no specific studies.

What scientific proof or peer reviewed studies have been published for the MonaLisa TouchTM and ThermiVA?

ThermiVA’s proof of performance has been visually confirmed vs. scientifically proven. Some professionals claim that before and after photos can prove their results. As of writing this article no peer reviewed studies were found for ThermiVA. The MonaLisa TouchTM has at least 16 peer reviewed studies some of which are cited below.


In comparing the two types of treatment, radiofrequency versus CO2 fractional laser, I would suggest considering them on a continuum. Radiofrequency is just not as intense, or strong as compared to fractional laser and so you can probably expect less of an effect and less durability.  And that’s exactly what we see in clinical practice.

As for which treatment is best for you, choose an experienced professional that is knowledgeable and already treats women for feminine conditions such as a urogynecologist, urologist, or obgyn. Choose the treatment that is backed by science and has proven results.


Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study. S. Salvatore et al.Menopause 2015 Jan 20. doi: 10.1097/GME.0000000000000401. [Epub ahead of print]

Vulvo-vaginal atrophy: A new treatment modality using thermo-ablative fractional CO2 laser. A. Perino et al. Maturitas. 2015 Mar; 80(3):296-301. doi: 10.1016/j.maturitas.2014.12.006. Epub 2014 Dec 25

Sexual function after fractional microablative CO2 laser in women with vulvovaginal atrophy. S. Salvatore et al. Climacteric 2014 Dec 16. doi:10.3109/13697137.2014.975197 [Epub ahead of print]

Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment. N. Zerbinati et al. Lasers Med Sci 2015 Jan, Vol. 30, No. 1:429-36. doi: 10.1007/s10103-014-1677-2. Epub 2014 Nov 20.

Microablative fractional CO2 laser improves dyspareunia related to vulvovaginal atrophy: a pilot studyS. Salvatore et al. Journal of Endometriosis and Pelvic Pain Disorders 2014. DOI:10.5301/je.5000184. Epub 2014 Jun 20.

A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. S. Salvatore et al. Climacteric Aug 2014, Vol. 17, No. 4:363-369. doi: 10.3109/13697137.2014.899347. Epub 2014 Jun 5.


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