Frequently Asked Questions


Even with the passage of time, many women still retain their youthful energy and enthusiasm, but post-menopausal changes can affect a woman's quality of life in unexpected ways.  Hormone replacement therapy may not be the best option for many patients.  Now there is an alternative therapy for vaginal revitalization that can help millions of women who are silently suffering and unable to undergo other treatment options. 

What is the MonaLisa Touch?

MonaLisa Touch is a medical laser that delivers controlled gentle energy to the vaginal tissue to revitalize the cells in the vaginal mucosa (vaginal tissue) so that these cells make more collagen, an essential ingredient in vaginal cell health.  The vulva (area outside the vagina) can also be treated to relieve symptoms.  It also treats vulvar conditions such as lichen sclerosis.

How does it work?

MonaLisa Touch implements CO2 laser energy that is delivered via a side-firing probe inserted into the vaginal canal.  A two-part pulse targets surface (epithelial) tissue and deep (lamina propria) tissue to promote vaginal mucosal revitalization.  A direct laser probe is utilized to treat the external tissues where indicated.

What clinical trials have been conducted on the MonaLisa Touch?

A multi-site study was conducted by Dr. Mickey Karram, Director of Fellowship Program on Female Pelvic Medicine & Reconstructive Surgery at The Christ Hospital, Cincinnati, OH and Dr. Eric Sokol, Associate Professor of Obstetrics and Gynecology at the Stanford University Medical Center.  That and several additional trials evaluating the laser treatment on postmenopausal women* and breast cancer survivors experiencing vaginal health issues have shown very positive results.  Dr. Gandell has trained in the technique with Dr. Karram.

Where can I have this done?
The MonaLisa Touch is an in-office procedure performed by physicians who treat symptoms of Genitourinary Syndrome of Menopause (GSM).  This is also referred to as Vulvovaginal Atrophy (VVA).   Dr. David L. Gandell is offering this procedure at Rochester Gynecologic and Obstetric Associates, P.C. located at 125 White Spruce Boulevard, Rochester, NY 14623.  You can schedule a consultation with Dr. Gandell by calling (585) 461-5940.   You do not need to be a patient of Dr. Gandell's to have a consultation or to get the procedure.  You may continue to get your routine gynecologic care from your own physician.                                                                 

Does the procedure hurt?
The procedure is virtually painless and requires no anesthesia.  If the external area is treated a topical numbing medication is used beforehand.  Some patients may experience some discomfort the first time the probe is inserted, but the actual treatment is not painful.  Many patients report that it feels like a gentle vibration. 

How long does it take?
Patients receive three treatments, spaced six weeks apart, with each taking less than five minutes to perform. 

When will I see results?
Most patients feel improvement after the very first treatment, although the procedure calls for three treatments that are generally spaced over a 12-week period. 

How long does it last?
Patients should expect to come back annually (every 12-18 months) for a single maintenance treatment.  MonaLisa Touch was first available outside the US where more than 5,000 patients had been treated worldwide with up to an 18-month follow-up.  Now over 50,000 patients have been treated with no reported complications. 

What if I don't get a maintenance treatment after 12-18 months? 

The underlying cause of the menopausal dryness, thinning, and fragility is low estrogen levels, and this is not changed by the procedure.  Thus, as with other treatments for this condition, these vulvovaginal symptoms will recur over just takes longer to recur after MonaLisa Touch than when other treatments are discontinued.  Fortunately, a single MonaLisa Touch treatment can restore the tissues for another year.  However, if the tissues are allowed to return to their original pre-treatment state, then it will be necessary to repeat the series of three treatments to achieve the same effect.

What are my limitations after the procedure is done?
Patients should refrain from sexual activity for 2-3 days.  This may extend up to 7 days if the area around the vaginal opening is also treated.  Otherwise, there are no restrictions.  Dr. Gandell will determine a post-procedure regimen that is right for you.

For which patients is this treatment appropriate?
The MonaLisa Touch is appropriate for any female who has gone through menopause, as well as those who are experiencing post-menopausal vulvovaginal symptoms as a result of a hysterectomy (if the ovaries are removed) or breast cancer treatments. 

What other conditions can be treated?

The MonaLisa Touch laser has been shown to be effective at treatment of a vulvar condition called lichen sclerosis, which causes chronic itching and irritation and thinning of the external tissues.  In addition, many women with urinary symptoms related to menopausal changes (urgency, frequency, incontinence, and recurrent urinary tract infections) report improvement in these symptoms.  Many women also report improved sensation and arousal and vaginal tone during intercourse, and often their partners note a positive difference in their vaginal tissues.

Who in my area is offering the MonaLisa Touch treatment?

The procedure first became available in Upstate and Western New York from Dr. David Gandell at Rochester Gynecologic and Obstetric Associates' 125 White Spruce Boulevard office in Rochester, NY beginning in July, 2015.  He trained with the device and technique with Dr. Karram, who was the physician who brought the therapy to the United States.  Dr. Gandell has developed a particular expertise with the procedure, and since providing the treatment has had many satisfied and gratified patients and couples.  Experience matters.  To schedule a consultation with Dr. Gandell, call 585-461-5940.  You can also obtain more information about Dr. Gandell and Rochester Gynecologic and Obstetric Associates at

How much will the procedure cost?

Patients should contact the office for additional information. 

Is this procedure safe for women with breast cancer?

Yes, MonaLisa Touch treatment is particularly well suited for patients who cannot, or prefer not to receive estrogen therapy.

Will the procedure be covered by insurance?

No processing code has been established yet to bill this procedure to insurance.  Some patients have been able to get reimbursement from their HSA accounts.

Do I need to switch to Dr. Gandell to get the MonaLisa Touch treatment through his office?

No.  You may see Dr. Gandell for the MonaLisa Touch treatment and continue to see your own provider for ongoing routine care.