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Private MonaLisa Touch vaginal laser in London, consultant gynaecologist led.

Fractional CO2 laser for genitourinary syndrome of menopause - dryness, dyspareunia and urinary symptoms, particularly where oestrogen is contraindicated or has not been enough on its own. Honest counselling on evidence included.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private MonaLisa Touch course costs in London.

Indicative ranges across UK private providers.

In short

£900–£2,700, over 12 weeks, plus annual maintenance.

Service Indicative range
Initial consultant gynaecology consultation £300–£450
Single MonaLisa Touch session (intravaginal) £350–£950
Standard course of three sessions £900–£2,700
External vulval handpiece add-on £100–£250/session
Annual maintenance session £350–£950
Follow-up review £180–£280

Prices vary by clinic, by consultant, by whether the external vulval handpiece is added, and by whether you pay per session or for a full course.

The problem

The right diagnosis, the right first-line, and only then the laser.

Vaginal laser is often over-sold and under-explained.

  • Sold laser without a diagnosis?

    Lichen sclerosus, dermatoses, infection and non-atrophic causes are missed all the time. A proper consultant assessment comes first.

  • Not been offered topical oestrogen properly?

    Vaginal oestrogen is safe, cheap and effective for most women. We optimise it first - laser is for when it is not enough or not usable.

  • Post-cancer and stuck?

    Where oestrogen is contraindicated after breast or endometrial cancer, MonaLisa Touch is one of the few options - but should be discussed with oncology.

When it helps

When MonaLisa Touch is the right step.

The presentations we see most, plus the one red flag that means a diagnostic gynaecology assessment before any laser.

  • Vaginal dryness

    The commonest GSM symptom - often persistent despite lubricants and moisturisers alone.

  • Superficial dyspareunia

    Painful penetration linked to atrophic changes - often the trigger for seeking treatment.

  • Vulval burning and itch

    Chronic vulval burning where lichen sclerosus and dermatoses have been excluded.

  • Recurrent urinary tract infection

    GSM contributes to recurrent UTIs after menopause - laser sits alongside vaginal oestrogen, not instead of it.

  • Urinary urgency and frequency

    Bothersome urgency and frequency from urethral and trigonal atrophy - often improves with vaginal treatment.

  • Post-cancer where oestrogen is off

    Breast and endometrial cancer survivors where systemic and often topical oestrogen are contraindicated - a common indication.

  • HRT-resistant GSM

    Persistent symptoms despite optimised systemic and topical HRT - laser can add measurable benefit for some.

  • Red flag: bleeding or new lesion

    Any post-menopausal bleeding, ulcer or persistent lump needs an urgent gynaecology assessment first - never laser.

Treatment options

Not every GSM plan looks the same.

What each option actually involves - laser is one tool alongside topical oestrogen, DHEA pessaries, moisturisers and systemic HRT.

  • MonaLisa Touch (fractional CO2)

    The best-known device - a fractional CO2 laser designed for the vaginal mucosa. Three sessions six weeks apart, plus annual maintenance.

  • FemiLift (fractional CO2)

    A comparable fractional CO2 platform used across UK clinics - same protocol and similar evidence base to MonaLisa Touch.

  • Erbium:YAG laser (IntimaLase)

    A non-ablative Er:YAG option used by some clinics. Slightly different mechanism and heat profile.

  • Radiofrequency devices

    Non-laser thermal devices (for example ThermiVa) - sometimes offered as an alternative or in combination.

  • Vaginal oestrogen (first-line)

    Local oestrogen (Vagifem, Ovestin, Estring, Blissel) remains the evidence-based first-line for GSM per NICE - we start here in almost every case.

  • DHEA pessaries (prasterone)

    An intravaginal option (Intrarosa) that works via local androgen and oestrogen effects - useful where oestrogen is preferred to be avoided.

  • Ospemifene

    An oral SERM for postmenopausal dyspareunia - an alternative for women who cannot use topical oestrogen.

  • Systemic HRT and lifestyle

    Systemic HRT helps some GSM symptoms but is prescribed for its own indications - laser and topical treatments sit alongside, not instead of it.

Safety and recovery

What to expect after treatment - honestly.

MonaLisa Touch is a low-downtime treatment. The things worth planning are the 48–72 hour rest after each session, realistic expectations on benefit, and the annual maintenance that most women need.

  • Discomfort during and after

    A warm, gritty sensation during treatment. Mild vaginal discharge and light spotting for 24–72 hours are normal.

  • Infection

    Uncommon but possible. New offensive discharge, fever or worsening pain in the days after treatment needs a same-day review.

  • Burns and scarring

    Rare with a properly maintained device in trained hands - one of the reasons we route to consultant-led clinics, not beauty salons.

  • Bleeding after sex

    Small amounts of spotting after the first few weeks are not unusual. Persistent or heavy bleeding needs urgent gynaecology review.

  • Under-response

    A minority of women get little to no benefit - the evidence is mixed and we counsel honestly rather than promising cure.

  • Contraindications

    Active infection, undiagnosed post-menopausal bleeding, pelvic malignancy under active treatment, or a pacemaker in the immediate treatment field.

  • Cervical screening

    Screening should be up to date before treatment starts and continued on the standard NHS schedule afterwards.

  • Post-cancer patients

    A candid conversation with your oncology team is essential - most oncologists are supportive but should be informed and consulted.

  • Red flags after a session

    Fever, heavy fresh bleeding, severe pain or offensive discharge - call the clinic the same day or head to A&E if you cannot get through.

Reading your treatment letter

Your vaginal laser letter in four parts. Read the last one first.

The letter the consultant sends you keeps to the same shape - assessment, treatment settings, response and next steps.

A UK consultant gynaecologist reviewing a vaginal laser treatment letter

A quiet reminder

Menopause language can feel clinical and cold - we translate the letter for you.

If you would like us to talk you through the letter before your review, or bring an oncology or dermatology opinion into the loop, just ask.

  1. 01 Header

    Diagnosis and indication

    The consultant confirms genitourinary syndrome of menopause, notes any mimics excluded (lichen sclerosus, dermatoses, infection), and states why laser was chosen over or alongside topical HRT.

  2. 02 Treatment

    Device, settings and sessions delivered

    Which laser platform, energy and pulse settings used, number of passes, and whether the external vulval handpiece was also used.

  3. 03 Response

    Symptom response and examination

    Patient-reported change in dryness, dyspareunia and urinary symptoms, alongside examination findings - vaginal pH, epithelial appearance and tissue elasticity.

  4. 04 Follow-up

    Maintenance, red flags and review timing

    Read this first: when you are being reviewed, the maintenance schedule, and what to ring the clinic about between sessions.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Vaginal laser is not typically covered by UK insurers or the NHS - it is treated as an elective private-pay treatment. Consultation costs may be covered where a formal menopause diagnosis is being made.

Frequently asked

Everything we get asked about MonaLisa Touch.

Quick answers on how it works, evidence, cost, post-cancer use and what the NHS covers.

  • What is MonaLisa Touch and how does it work?

    MonaLisa Touch is a fractional CO2 laser designed for the vaginal mucosa. A specialised probe delivers a pattern of micro-columns of laser energy into the vaginal wall. The theory is that controlled micro-injury stimulates collagen remodelling, improved vascularity and thicker, better-lubricated epithelium - addressing the changes of genitourinary syndrome of menopause.

  • How many sessions do I need and what does it cost?

    The standard induction course is three sessions six weeks apart, followed by an annual maintenance session. An initial consultant gynaecology consultation runs £300–£450.

  • What is the evidence, and what is NICE’s position?

    Observational studies and some randomised trials show improvement in dryness and dyspareunia scores. A widely cited sham-controlled trial (Li et al., JAMA 2021) found no significant benefit over sham, which tempered enthusiasm. NICE has not endorsed vaginal laser as a routine treatment. We are honest about this: benefit is real for many women but not universal, and topical oestrogen remains first-line.

  • Is it safe after breast or endometrial cancer?

    MonaLisa Touch is often used in breast and endometrial cancer survivors where systemic and topical oestrogen are contraindicated. It is one of the more common indications. We ask you to discuss it with your oncology team first - most are supportive, but the conversation should happen.

  • Does the NHS fund vaginal laser?

    No. Vaginal laser is not funded on the NHS in England, Scotland, Wales or Northern Ireland - NICE has not endorsed it and it is not commissioned. NHS GSM care remains topical oestrogen, DHEA pessaries, moisturisers and, where appropriate, systemic HRT. Private laser is an add-on for women where those options are exhausted, contraindicated or declined.

  • Does the treatment hurt, and is there downtime?

    Most women describe a warm, gritty sensation during the 3–5 minute treatment. Local anaesthetic gel is available but rarely needed intravaginally; the external vulval handpiece sometimes needs a numbing cream. Sex, tampons and swimming are avoided for 48–72 hours. There is otherwise no meaningful downtime - most women return to work the same day.

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