Use of a fractional laser to treat vaginal complaints is an emerging technology in gynecology. We have recently begun offering this treatment to appropriate patients because we think the treatment may be able to help some women who don’t tolerate other therapies.

However, there are few high quality studies to tell us how effective this treatment is, so we recommend that women try other treatments first. But please note, this is not vaginal rejuvenation.

Q: What is fractional vaginal laser treatment?

A: The laser we use are the same as those used by dermatologists on the face and body to treat scars, discoloration and other skin conditions.

The vaginal laser creates tiny holes in the vaginal lining to stimulate your body’s natural repair functions and make the vaginal lining thicker. The treatment is called “fractional” because the holes are made in only a small fraction of your total vaginal lining.

Q: How well does it work?

A: Only one randomized study has compared laser treatment to vaginal estrogen cream. Results from this study showed similar effects from both treatments on vaginal dryness and pain with sex.

Other studies have been conducted without a comparison group. They showed improvement in symptoms for 80-90% of women treated with laser. However, this could be due to a “placebo effect,” where believing that things will get better works as well as the actual treatment.

Q: Why does Mass General offer this treatment?

A: We believe that there is evidence the laser may provide symptom improvement for women who can’t or don’t want to use estrogen to treat menopausal vaginal symptoms.

Q: Are there risks associated with the treatment?

A: The treatment may not work, and you may not have any improvement in your symptoms.

Your symptoms may worsen after laser treatment, but this is rare.

Any time a laser is used, there is a risk of burns or damage to the skin or eyes. For this reason, eye protection must be worn during the laser treatment.

Q: What about the FDA warning?

A: An FDA statement in July 2018 expressed concern about inaccurate marketing statements for multiple devices from multiple companies, including the device we use here at Mass General.

Laser and radio frequency devices being marketed for “vaginal rejuvenation” are used by many different types of providers, including non-medical personnel. However, we feel that in the hands of a gynecologist and used for treatment of specific vaginal and vulvar symptoms along balanced and complete counseling about treatment options, laser treatment is still a reasonable and safe option for our patients.

Q: Is it covered by insurance?

A: Currently, this procedure is not covered by insurance and must be paid out-of-pocket. Payment for the treatment will be collected at the beginning of each visit. The current standard is to start with three treatments, each six weeks apart.

In addition, several experts recommend getting an additional treatment each year.