Word from the expert: Dr. Fiammetta Trallo – Intimate sexual disorders

DEKA Intimate intervista Fiammetta Trallo parte 1
Sooner or later comes the menopause… and intimate sexual disorders

Menopause is a natural event and sooner or later we all have to face it.
The cause is a decrease in the production of oestrogen hormones by the ovaries. In some women it is more pronounced, in others less, which is why we do not all have the same symptoms or have them to a greater or lesser extent.
What is certain is that we feel a change in our whole body. The most conspicuous phenomenon is the cessation of menstruation, but from the genital apparatus to the blood vessels, from the brain to the bladder, to the muscles, bones and skin, our physique is affected by this mutation.
If menopause-related osteoporosis is much talked about and prevention becomes a fundamental weapon, to alleviate the annoying hot flashes, especially at night, there are many effective products, including natural ones, little is said about changes that emerge in a more subtle way and that tend not only to persist but also to worsen: sexual intimacy disorders.

Foto Intervista Dottoressa Fiametta Trallo_2

We talk about it with Dr. Fiammetta Trallo, specialist in gynaecology and obstetrics

How do women deal with intimate disorders?

Intimate and sexual disorders are widespread among women, especially in pre- and post-menopause, but also in post-partum and after cancer therapies. Very few women, however, recognise the symptoms and consult a specialist to find a solution. Very often they do not even talk about it with friends or sisters because they confide very little about these intimate topics. And this is not good. They often find it difficult to talk about it even with their gynaecologist.

In my personal experience I also prefer to investigate with direct questions before even starting the examination on the gynaecological couch. In this way, I try to put my patients at ease by being available to listen not only to gynaecological problems but also to those related to the sexual sphere. When the hormone deficiency of the menopause alters sexual function, the discomfort is primarily psychological with repercussions on the quality of the couple’s relational life.

What are vulvo-vaginal disorders due to hormone deficiency?

Formerly referred to as vulvo-vaginal atrophy, today it is more correctly called uro-genital syndrome, because the bladder and vagina are in close contact and their wellbeing is mediated by oestrogen hormones, which are lacking or significantly reduced during menopause.

Hormone deficiency reduces the production of collagen throughout the body, a valuable substance that controls the elasticity of the body’s tissues. The effects “can be seen on the face and felt in the most intimate parts”. The vulvo-vaginal mucosa thins and both lubrication and elasticity are reduced. And from there, symptoms such as burning, itching and dryness can become a more or less constant intimate discomfort that generates pain during intercourse. Impaired sexual function can make any form of pleasure beyond desire difficult. Reaching orgasm becomes a feat. And the drop in libido due to hormonal deficiency is made worse. Let us remember that it is not enough to do what the mind wants, we must also see what the body can do! If the pleasure organ is not able to function properly, desire alone is not enough.

The risk is to enter a “vicious circle”: the woman avoids intercourse because of the emotional and physical discomfort she feels and this leads to a diminishing desire for sexual intimacy.

The bladder is also affected. Hormonal decline alters the dynamics of bladder filling and emptying and generates urinary discomfort: incontinence, increased frequency, urgency and a sense of incomplete emptying. Another disorder is post-coital cystitis. It appears 24-48 hours after sexual intercourse due to trauma to the thinned urogenital tissues and may be associated with vulvo-vaginitis.

What solutions do women have at their disposal to combat intimate and sexual disorders?

It is important to have a correct diet and hygiene style, one can use long-term natural therapies and short pharmacological therapies in the acute phase, but above all, I have obtained excellent results with the latest generation of laser therapy for vaginal photorejuvenation with long-lasting benefits. I have been using DEKA’s MonaLisa Touch™ CO2 laser treatment for many years, to the great satisfaction of my patients. And mine too, both as a gynaecologist who helps women solve a not insignificant problem and because I too have undergone this therapy and obtained considerable benefits.

MonaLisa Touch™ restores vaginal lubrication and elasticity and improves the function of the bladder and pelvic floor, restores the vaginal mucosa conditions typical of the fertile age and the aesthetics of the intimate parts with long-lasting effects. It is a highly effective, painless, non-invasive and non-injection therapy, does not stimulate hormone production even locally, and is free of side effects. An excellent alternative to minor surgery, which is not always risk-free, and hormone therapies, especially for women who do not want to or cannot take them.

How does MonaLisa Touch™ work?

Using a special vaginal probe, laser beams are emitted inside the vagina. The transmitted energy increases blood circulation, brings more nourishment and stimulates the production of collagen and elastic fibres through the reactivation of fibrocytes into fibroblasts, the cells responsible for the proper functioning of tissue elasticity including vulvo-vaginal and urinary tissues.
It is not, therefore, a mere assembly of residual elastic fibres, but a true ex-novo production of collagen and cellular matrix.

The mucous membrane is thus regenerated and consequently rejuvenated, becoming hydrated, lubricated and elastic again, with a significant improvement in sexual response and urinary symptoms.

As confirmed by histological studies, one month after the first session the vaginal mucosa already shows clear signs of rejuvenation as well as significant thickening of the mucosa.

This concludes our interview with Dr. Fiammetta Trallo. We will soon publish the second part.

The treatment that resolves the most common symptoms

Women's intimate health DEKA Intimate

Vaginal atrophy is a very common condition, especially among menopausal or postpartum women, but it can also occur early on. The most common symptoms are vaginal dryness, laxity, burning, pain during sexual intercourse and mild urinary incontinence. To all this, however, there are remedies. Let’s discover the MonaLisa Touch™ treatment together.


What is MonaLisa Touch™ treatment?

MonaLisa Touch™ is an intra-vaginal treatment that improves the condition of the mucosa lining the walls of the vagina through minimally invasive laser-assisted procedures. MonaLisa Touch™ is not an aesthetic treatment, because the action of the laser restores the functionality of vaginal tissues that have been lost over time.

For which women is MonaLisa Touch™ laser treatment most suitable?

For any woman who wants to prevent or treat the effects of an oestrogen drop at the intimate level (during the menopause, or after childbirth, after cancer treatment or following eating disorders such as anorexia). The most common symptoms are vaginal dryness, laxity, burning, pain during sexual intercourse and mild urinary incontinence. MonaLisa Touch™ is the ideal treatment for those seeking an effective but less invasive procedure than traditional surgical or pharmacological techniques.


Salute intimate femminile DEKA Intimate

What kind of results can I expect?

Treated patients report a decrease in dryness, burning and itching immediately after the first treatment. Improved sensitivity during sexual intercourse is therefore a natural consequence. There is also a reduction in symptoms related to urinary incontinence (mild, stress incontinence).

Is it painful?

No, the treatment does not require any anaesthesia. The sensation felt is just a small vibration.

How many treatments are needed?

Treatment usually involves three applications about a month apart, but sometimes, depending on the pathology and clinical situation, a fourth treatment may be necessary.

After how long is it possible to resume sexual activity?

Three to four days of rest is usually recommended before resuming regular sexual activity. However, your doctor will be able to give you more specific instructions based on the outcome of the treatment.

Can MonaLisa Touch™ also treat a dilated vagina?

The generic term “wide vagina” (or dilated vagina) usually refers to a condition where the size of the diameter of the vaginal canal has increased. Often this is caused by natural but traumatic events such as childbirth or the relaxation of tissues due to the natural ageing process. In these cases, it is very important to assess the cause and the actual condition of the vaginal canal in order to rule out problems such as vaginal prolapse or muscular involvement. With the fractional CO2 laser, it is possible to treat those cases where the “wide-vagina” is due to a loss of mucosal tone.

Are there any risks?

No, MonaLisa Touch™ is a safe treatment that is performed on an outpatient or day hospital basis. Most women who have tried it report only transient side effects such as slight redness or swelling that usually resolve with a day or two of rest.

How does recovery take place?

Most women report slight local sensitivity following laser treatment and in the days immediately following the session. Many report returning to their normal routine one to three days later. During the healing process, you may be advised to refrain from lifting weights or to avoid particular activities such as hot baths and exercise: your doctor will give you more specific advice on what to do to speed up recovery.

How long do the effects of the treatment last?

The results are immediate, already after the first treatment, and are bound to improve over the following months. The regeneration process that is triggered lasts 40-60 days after which it is advisable to repeat the treatment.

Are there any contraindications?

There are no absolute exclusion criteria for the MonaLisa Touch™ other than those related to severe local and systemic pathologies. In principle, all women who suffer from intimate discomfort such as dryness, burning, itching or laxity can benefit from it, but your doctor will determine your compatibility with this treatment.

Word to the expert: Dr. Fiammetta Trallo – Intimate sexual disorders (second part)

DEKA Intimate intervista Fiammetta Trallo parte 2
No one escapes the menopause…don’t worry, we have the tools to deal with it!
MonaLisa Touch laser technology – part two.

This is the second part of our interview with Dr Fiammetta Trallo, aspecialist in gynaecology and obstetrics, with whom we talked about intimate sexual disorders related to the menopause and the MonaLisa Touch laser technology to counteract them.
(If you missed the first part of the interview, click here)

For which women and for which conditions is DEKA’s MonaLisa Touch treatment indicated?

As we have already mentioned, MonaLisa Touch is a treatment based on a special fractionated CO 2 laser system, specifically designed for the vaginal mucosa, which prevents and resolves the effects of the reduced production of oestrogen on vaginal tissue (typical of the menopause and post-partum) by reactivating the production of new collagen and restoring the vaginal mucosa conditions that are characteristic of the fertile age. A well-tolerated, non-invasive treatment lasting only a few minutes and
with no recovery time.
In practice, the woman feels less pain upon penetration due to both increased lubrication and the improved elasticity of the vaginal entrance. Urinary symptoms also improve. The restored functionality of the urethra and bladder prevents post-coital cystitis and controls small involuntary leaks of urine.
As the average life span increases, women find themselves spending a third of their lives in menopause; these are strong, motivated women, much “younger” than their grandmothers were. The lack of a satisfying sex life is frustrating for them.
MonaLisa Touch is indicated for all women with intimate disorders of the genito-urinary sphere, at any age and not only after the menopause. For example, it is indicated for women with sexual and urinary discomfort in spontaneous pre- and post-menopause, early menopause or menopause induced by cancer treatment.
Other indications are Vulvar lichen sclerosus et atrophicus, Sjögren’s syndrome and all diseases of the
connective tissue that affect the vulvovaginal area.
It is also highly effective for intimate discomfort immediately post-partum and relapsing post-coital vulvar

What must be done before treatment?

We start with the essentials: an accurate medical history taken by the gynaecologist; this is followed by a pap smear and a genital colposcopic evaluation of the vulvar area in particular, to assess whether there is any narrowing of the vaginal introitus or stenosis of the posterior labial commissure, which may require preliminary treatment before starting the therapy with MonaLisa Touch. The treatment must be as customised as possible, so it is important to have set the optimal parameters before starting.
Vaginal treatment improves the lubrication and elasticity of the vagina and bladder. Higher parameters, in particular laser power, are used. Vulvar treatment improves vulvar lubrication and the elasticity of the vulva and perineum. Lower
parameters are used. The peri-urethral treatment acts on the urethra, the duct that connects the bladder with the outside; its
proper functioning prevents post-coital cystitis and controls the small involuntary leaks of urine that occur
after exertion. For aesthetic purposes, the labia majora and the mons Veneris can also be treated for tissue plumping.

How many sessions are required and how do they take place?

The treatment normally includes three stages plus an optional fourth, lasting 10 to 15 minutes. One session per month is scheduled, with a benefit lasting up to 12-18 months, then an annual booster session.
The first benefits – reduced burning, itching and relief from the feeling of dryness in the intimate area – are felt after the first session.
The treatment is completely painless. It can be a little uncomfortable at the vaginal introitus or on the posterior labial commissure, i.e. in those areas of mucous membrane that in themselves are more painful and sensitive.
In these cases, the parameters of power, spacing, delivery duration and depth of the laser beam are changed. Some burning in the vulvar area may persist until the evening. In the following 2-3 days, pinkish discharge may occur, which resolves spontaneously. Sexual activity can be resumed after 5-6 days. No woman should experience even minimal suffering when undergoing regenerative treatment of the genito-urinary mucous membranes.