I’ve spent thousands on vaginal rejuvenation. Here’s what it did – and didn’t – do.

“It really hurts to have sex,” I said to my doctor. “Like a lot.”

I was sitting in a hospital gown on the exam table in my family doctor’s office in Santa Fe, New Mexico. It was the same table I had sat at during both of my pregnancies and where I had been diagnosed with breast cancer three years earlier.

“I’m so sorry,” my doctor said. “I know how it feels to go through menopause. Especially since you went through it overnight.”

She was the one who diagnosed me with cancer. I had found a small lump on my right breast and immediately called their office. Our appointment fell on Halloween 2017 and she was dressed as Snow White, wearing full face paint and a black wig.

“You’re one of the lucky ones,” she said as I sat on the table and cried. “You don’t need chemotherapy and you’ll be fine.” My doctor was right – I was lucky. I caught it early, and with breast cancer, early detection is everything.

My treatment consisted of a mastectomy, reconstructive surgery and 10 years of targeted hormone therapy – to kill the estrogen in my body and lower my risk of cancer coming back. The goal of these hormone treatments — for premenopausal women — is to propel you through menopause. It worked. In a matter of weeks, I went from a healthy 37-year-old menstruating woman to a postmenopausal cancer survivor with hot flashes and bone pain. I suffered from vaginal irritation, something I later learned was vaginal atrophy. The only thing that didn’t atrophy were my post-surgery breasts – they looked bouncier than ever. But while my boobs felt like 16 again, my vagina felt like 61. It was a total mindfuck.

“It hurts,” I complained. “Only… all the time. And especially when it comes to sex.”

“Menopause makes it very uncomfortable — almost impossible — to have successful intercourse,” she said matter-of-factly. “Have you heard of vaginal rejuvenation? A colleague of mine in Albuquerque offers laser treatment in her office. I think you would be a great candidate for that.”

The author takes a selfie at her first mammography appointment. “I didn’t know what to expect at the time,” she writes.

Courtesy of Anna Sullivan Reiser

An hour later I was home and I googled laser vaginal rejuvenation. Eventually I found a reputable women’s health site with information about the treatment. Above the medical description was a photo of a smiling woman in her 60s, wearing a pink button-down shirt. She had performed the treatments and appeared to be enjoying “successful intercourse.”

The type of vaginal rejuvenation treatment I considered gently “rejuvenates” the vagina by delivering a type of therapy known as fractional CO2 (carbon dioxide) laser energy to the soft tissues of the vaginal wall and using a hormone-free treatment for the vagina is deployed atrophy. Vaginal atrophy — for those who haven’t traveled to the Sahara Desert during menopause — is vaginal dryness of the next level. It’s a side effect of menopause – practically a guarantee. For many women and people with vaginas, vaginal estrogen creams can provide adequate relief from the pain of intercourse caused by vaginal atrophy. For women like me – who are proactively killing the estrogen in their bodies with mega-drugs – research continues on estrogen creams, rings and pills and whether they are safe to use. Right now it’s something I’m not comfortable with.

I was excited to discuss what I had learned with my husband. While we were dealing with two toddlers — while simultaneously recovering from a life-threatening illness — treating sexual dysfunction was on our to-do list but hadn’t yet become a crisis in our marriage. Together we have defined two main disadvantages of the treatment. The first was the price tag. The laser treatment consists of three sessions spaced a few months apart. I was budgeted a total of $3,000 for the three sessions. Insurance does not cover the cost of vaginal rejuvenation, although you may be able to be reimbursed through a flexible spending account (FSA). I don’t have any of these.

The second concern was risk. Most websites I researched did not mention any risk associated with the treatment. But of course there is a risk if you decide to have your vagina lasered. Some women have experienced excruciating pain and, in very rare cases, vaginal burns during treatment. Despite all this, and because I was one of the lucky ones who had access and could afford the treatment, I decided to give it a try.

The author and her husband Alex at the Inn in Vermont, where they were married.
The author and her husband Alex at the Inn in Vermont, where they were married. “It was on our 8th wedding anniversary,” she writes.

Courtesy of Anna Sullivan Reiser

A few weeks later I was on my way to Albuquerque for my first laser treatment in the desert mesas. When I arrived at the small gynecology practice, I was greeted by a young and lively receptionist. I told her in a low voice that I was there for a vaginal rejuvenation. She asked me to repeat myself. I did. She giggled nervously and asked me to wait. I watched her confer with a colleague before returning to the window. “I’m sorry,” she said, amused. “I’d never heard of that.” I gave her a look that meant, Menopause is coming for you too, young lady.

Eventually, I was led into an examination room and given a gown. A nurse entered the room and applied a numbing cream to my labia. While waiting to be stunned, I spotted the laser treatment in a corner of the room. It was a large machine with a long, slender wand. It looked like something you might see in a dentist’s office. Then the gynecologist walked in – an elderly woman with a low, hippie-style voice – and told me how excited she was to have the opportunity to perform the procedure. “Have you used the laser before?” I asked nervously. “Only a few times,” she replied. I tried to ignore the sudden wave of panic that swept over me. She turned on the machine and it made a loud vibrating noise. As I sat back, a slogan from an old Virginia Slims commercial came to mind: You’ve come far baby

The initial treatment went well. I had light vaginal bleeding for a few days, which was to be expected. The laser creates tiny micro abrasions on the vaginal wall, increasing blood flow and stimulating the growth of new blood vessels – essentially bringing new life to your vagina. I didn’t feel any pain during the treatment, although it was a little uncomfortable and uncomfortable. After the first session I immediately noticed something. My vagina seemed happier. In fact, it didn’t hurt at all.

My gynecologist told me to have sex between sessions to maintain my new elasticity. I felt so empowered by the positive results of the first treatment that I couldn’t wait to jump into bed with my husband. But when it came time to get down to business, I was very disappointed to find that the penetration continued to be very painful.

“I’m sorry,” I said to my husband after we tried—unsuccessfully—to have sex. “I can’t do this, it hurts too much.” I was in tears. We were both frustrated. Would I ever have sex again?

The author, her husband and two children on Halloween 2017, just hours after her doctor diagnosed her with breast cancer.
The author, her husband and two children on Halloween 2017, just hours after her doctor diagnosed her with breast cancer. “We’re trick-or-treating on Canyon Road in Santa Fe, New Mexico,” she writes.

Courtesy of Anna Sullivan Reiser

I brought this question with me to my next appointment in Albuquerque. My gynecologist told me to wait until all three treatments are complete before drawing any conclusions. But the results of the second treatment were not so remarkable. And the same was true for the third and final treatment. It seemed to me that the greatest benefits of vaginal rejuvenation came after the first treatment. It had a very positive effect on the overall well-being of my vagina, but it didn’t fix the painful symptoms I was having during intercourse.

Six months after my first doctor’s visit, I was back in the exam room and sharing my experiences. My doctor and I agreed that there is still a long way to go in researching and making more resources available for women’s health. Most women cannot afford expensive vaginal laser treatments and instead learn to normalize their pain or simply avoid talking about it.

Has vaginal rejuvenation fixed the painful symptoms I experienced during sex? no Am I comfortable using an estrogen cream? Again no. But I think about the waiting room at Dana Farber Cancer Center – and I think I can live with that. The question is why should I? Why is there a little blue pill for erections and no effective medication for vaginal dryness? Once again it seems we’ve caught the wave.

Before I left, my doctor wrote me a prescription for lidocaine, a numbing cream.

“Applying it twenty minutes before sex really helps,” she said. Before leaving the room, she turned and gave me a half smile as if to say: Welcome to menopause, we’ve come a long way baby. But do we?

There are a few other non-estrogen treatments for vaginal atrophy – and maybe I’ll try them one day. Right now, my partner and I are exploring what “successful intercourse” means to us. Penetration is just one way of having sex – there are lots of fun things to do.

After I was catapulted into menopause, we were forced into these uncomfortable but ultimately fruitful discussions—and in many ways, they brought us closer. We’ve redefined what sex and intimacy looks like to us – and that feels like an achievement.

Anna Sullivan Reiser is a writer and psychotherapist. She writes for The Insider and is the co-host of the upcoming podcast Healing + Dealing, which explores young survival issues. She lives in Santa Fe, New Mexico with her husband and two children. You can contact her at annasullivanreiser.com or follow her on Instagram @healinganddealingpod.

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