The Science of Sex is a new column from Broadly exploring the tech behind the complicated and fantastic ways we get off—because sex is sexy, but science is sexier. This week, we learn whether lasers can help women with sexual dysfunction enjoy sex again.
Women's sexual health remains consistently under-resourced and under-researched the world over. While Viagra is available on many health insurance plans, many still don’t even cover women's preferred forms of birth control. And female sexual dysfunction is often bottom of the list when it comes to healthcare-led responses: We expect women to put up with painful sex or loss of libido as a result of getting older, and don't spend too much time worrying about it.
A common side effect for women experiencing menopause or undergoing radiotherapy or chemotherapy is persistent vaginal dryness. Your sex drive plummets; sex becomes painful; orgasms become elusive. Conventional pharmaceutical treatment offered by some healthcare services include vaginal estrogen and hormone replacement therapy, but many women don't receive medical treatment or make do with over-the-counter lubricants. Some end up abstaining from sex altogether.
But could there be another way—one that doesn’t require externally applied gels or hormone-based therapies?
Although shining a laser on your vagina to improve your sex life sounds like science fiction rather than medical reality, there is some research supporting its effectiveness.
Not just any lasers, though. (While your local Laser Quest may be pleasing in other ways, it’s of no medical benefit.) The technology only works using fractional carbon dioxide (CO2) lasers, which are often used by dermatologists for skin resurfacing. In the US, this therapy is marketed as the Mona Lisa Touch: a probe is inserted into the vagina, where the laser emits light beams that remove the upper damaged levels of skin, and stimulates new cell production in the layers below. (Other manufacturers have patented similar technologies.)
One 2016 evidence review, published in the International Journal of Women's Dermatology concluded that, “in the hands of well-trained physicians, energy-based devices are likely to benefit millions of women by aiding them in reclaiming, relishing, and reveling in their femininity at full capacity." But how can lasers actually help rejuvenate your sex life?
“What happens is, when a woman goes through menopause the lining of the vagina becomes very thin, and the top layer becomes essentially non existent, so when someone attempts to have intercourse, not only is there no lubrication, but the tissue has no elasticity,” explains Dr. Lauren Streicher, an expert on the vaginal application of CO2 laser technology. She's an associate professor at Northwestern Medicine Center for Sexual Medicine and Menopause, and frequently treats female patients suffering from vaginal dryness using the technology.
“What the laser does is make microscopic wounds in the vaginal tissue,” Dr. Streicher says, explaining that this technology is often used on other parts of the body, such as for cosmetic laser resurfacing. “The wounds are very minimal—no anesthesia is needed. There’s zero pain. But when the laser emits this little beam, the body’s own wound healing system mechanisms start to work, and there’s increased collagen formation and new blood vessels formed. As a result of this, you get a resurfacing of the vaginal lining.”
Practically speaking, the treatment lasts about five minutes, and a single course of treatment consists of three appointments, six weeks apart. Apart from some anesthetic gel, no pain relief is required. Dr. Streicher tells me that the probe is inserted vaginally to resurface the inner tissue, as well as being used on the outer vulva and vaginal opening.
Post-laser therapy, Dr. Steicher claims that her menopausal patients’ vaginas are comparable to those of younger women. “When you do a biopsy, the tissue is thick, it has a lot of nice folds, it responds as it did prior to menopause.” Think of the laser as a portable time-machine for your vagina, restoring its elasticity and ability to produce lubrication.
Despite this, the application of lasers vaginally hasn't been FDA-approved as a recognized treatment because of limited evidence. An American College of Obstetrician's position statement from 2016 acknowledged that "initial data indicate[s] potential utility" and called for additional research around the treatment.
I ask Dr. Streicher whether laser technology can also help women who are struggling to achieve orgasm. “Theoretically, yes,” she tells me, “because you’re increasing blood flow to the genitals. Anything that increases blood flow will theoretically increase orgasmic function.” (As we become aroused, more blood flows to our genitals—but women with sexual dysfunction experience diminished blood flow.) However, Dr. Streicher hasn't yet explored laser's potential to help anorgasmic women in this way—she's waiting for more evidence to come out.
Plus, she adds, anything that alleviates pain during intercourse—a major side effect of vaginal dryness—may generally lead to increased libido. “People don’t want to do things that hurt. So indirectly, yes, lasers will increase libido, because if you take away the pain, they’ll be more amenable to sexual activity.”
But if lasers really do work for vaginal dryness and could even help women reach orgasm, why aren’t they being more widely used? Because CO2 lasers are expensive, says Dr. Streicher.
“Laser isn’t covered by insurance, so it’s not as popular,” she explains. “And the cost is quite expensive—between $3,000 and $4,000 for a course, depending on where you live.”
One solution would be for women to lobby insurance providers to cover vaginal laser therapy—like the men who filed lawsuits to ensure Viagra coverage in the early days of the drug.
Until then, vaginal laser therapy looks likely to remain an option only for the wealthy. But remember: don’t get naked at Laser Quest. That won’t work.