About the Laser Treatment of Vaginal Atophy and Dyspareunia.
Gynecologists and urogynecologists around the globe know Dr. Zipper for his remarkable contributions to the development of lasers for use in pelvic medicine. Dr. Zipper is the inventor of laser Incisionless Vaginal Rejuvenation® and the GyneShape™ laser. Dr. Zipper is also the CEO of UroShape, LLC a laser company actively developing lasers for pelvic pain. As you may or may not be aware, there are many lasers now being used to treat vaginal atrophy and its symptoms, pain with intercourse, itching, and burning. Examples include the Mona Lisa Touch® laser, Selene Touch™, diVa™, FemTouch™, and FemiLift™, Dr. Zipper wants you to know that they all work on the same basic principle, they drill tiny little laser holes in the vaginal wall which stimulates the growth of new and healthier tissue. Dr. Zipper also wants you to know that, although each company would like you to believe that their laser is superior, this technology is new and there is very limited data to support such claims. Indeed, his research suggests that each of these lasers are equally capable treating vaginal atrophy and it may be several years before inferiority or superiority is demonstrated. At this time, Dr. Zipper recommends that you first choose a physician with ample experience with lasers and next make sure your physician is using an FDA cleared laser.
What is Dyspareunia?
Dyspareunia is a medical word for pain with intercourse. This can be caused by vaginal atrophy, vaginal surgery, trauma, assault, infection, and very commonly by pelvic muscle spasm (tension myalgia and myofascial pain syndrome). Although the lasers described on this page may be very effective in treating vaginal atrophy related dyspareunia, they will not help with other forms of dyspareunia.
What is Vaginal Atrophy?
As a women ages and estrogen declines, the lining of the vagina becomes thin and fragile. Once this begins to happen, women often begin to experience vaginal dryness, itching, tenderness, and worsening pain with intercourse (dyspareunia). Unfortunately, oral hormones do not typically help. Vaginal estrogen cream, used several nights each week can help. However, it is messy and it must be used forever. Vaginal estrogen may also be administered as a vaginal pill or a vaginal ring. A pill called Osphena® may also help. However, you will be putting a chemical in your body every day for the rest of your life. Additionally, creams and pills will not work for every women.
Can Vaginal Atrophy Cause Urinary Tract Infections (UTI)?
Yes. Indeed, the only treatment that has consistently be shown to help women with recurrent UTIs is the treatment of vaginal atrophy. So, if you have recurrent urinary tract infections and also have vaginal atrophy, consider treating your atrophy. You may consider vaginal estrogen or any of vaginal lasers such as those discussed on this page.
What is an FDA cleared laser?
Dr. Zipper wants you to know that FDA clearance for marketing means that he FDA has determined that a laser is similar (“substantially equivalent” or SE) to an already cleared laser that has been shown to be safe and effective, or itself has been shown to be safe and effective to another cleared laser. As you might be guessing, this can go on and on to the point that it becomes difficult to find the original laser that was tested. The original laser can even be a laser that was approved by the FDA prior to today’s rigorous approval process. Hence, it is important that your doctor carefully evaluates the laser he or she is using.
What is an Off-Label Use of a Device?
When a laser, or any medical device is cleared for marketing, it is cleared for a particular indication. By way of example, the lasers commonly used to treat vaginal atrophy were not cleared for vaginal atrophy. These lasers were cleared for indications such as skin resurfacing or photocoagulation. As you might have guessed, resurfacing of or photocoagulation of the vaginal skin (mucosa) may improve vaginal atrophy. Makes sense right? Indeed, it does. So, once a device is cleared to be marketed for an indication, it may be legally marketed for that indication only. However, a doctor may use such device for a different indication, as long as you are informed of such and understand the potential risks and benefits. This is called off-label use. As these vaginal lasers are indeed being used to resurface or photocoagulate the vaginal mucosa, this novel use of skin resurfacing and photocoagulating lasers may not be off-label.
Why do we use the Selene Touch laser?
As discussed earlier herein, Dr. Zipper believes that there is no one laser that has clearly demonstrated superiority in the treatment of vaginal atrophy. Dr. Zipper is not only is the CEO of his own laser company, but has been an inventor of laser methods and devices for many years. When Dr. Zipper asked many laser companies to allow him to test their laser and explore them for potential problems, only Focus Medical, the makers of Selene Touch, were willing to allow Dr. Zipper to do such an analysis. Of even greater concern, one of the biggest manufacturers could not even answer simple questions about the dosing of their energy. When asked about his experience with the Selene touch here is what Dr. Zipper had to say; “When it comes to the treatment of vaginal atrophy and dyspareunia, size and speed matter. The small size of the Selene probe is very important. The automatic hand piece makes Selene treatment one of the fastest on the market. My patients and I both love the fact that a treatment is typically painless and completed in under 3 minutes”. When asked about problems, Dr. Zipper stated: “Focus medical has answered my request to add data collecting software to its laser platform. This means that I am now collecting meaningful data, data that others seem to be missing. So far, so great”.
Is Selene Treatment Expensive?
Not in our office. A full treatment regimen is typically three visits. We want all women to get the full treatment and therefore get the full benefits. So, how do we do that? We do the third treatment for free.