When researching vaginal rejuvenation options in Toronto, two names come up frequently: MonaLisa Touch and ThermiVa. Both are non-surgical treatments designed to improve vaginal health, but they use fundamentally different technologies and may be better suited to different patients. This MonaLisa Touch vs ThermiVa comparison covers how each works, what to expect during treatment, recovery, and which patients tend to benefit most from each approach. At FemRenew, Dr. Fay Weisberg helps patients navigate these choices with evidence-based guidance.
How MonaLisa Touch Works
MonaLisa Touch is a fractional CO2 laser system that delivers controlled thermal energy to the vaginal wall. The laser creates microscopic channels in the tissue, which triggers the body’s wound-healing response. This process stimulates new collagen production, restores the vaginal mucosa’s thickness, and increases blood flow and natural lubrication.
The standard protocol involves three sessions spaced six weeks apart, with each session lasting approximately five minutes. No anaesthesia is required, though a topical numbing agent may be applied for patient comfort. Most patients report minimal discomfort during the procedure. Recovery is straightforward — patients are typically advised to avoid intercourse and tampon use for 48 to 72 hours after each session.
Explore FemRenew’s full range of technology-based treatments to see how MonaLisa Touch fits within our clinic’s offerings.
How ThermiVa Works
ThermiVa uses radiofrequency (RF) energy rather than laser light. A small, temperature-controlled probe is applied to both the external and internal vaginal tissue, gently heating the area to stimulate collagen remodelling and tissue tightening. The RF energy penetrates deeper layers of tissue without creating the micro-injuries that laser treatments produce.
Treatment involves three sessions spaced approximately one month apart. Each session takes 20 to 30 minutes — longer than MonaLisa Touch — and is described by most patients as a warm, comfortable sensation. No anaesthesia or numbing cream is needed, and there is zero downtime. Patients can resume all activities, including intimacy, immediately after treatment.
MonaLisa Touch vs ThermiVa: Key Differences
Understanding the distinctions between these treatments helps you make an informed decision:
| Feature | MonaLisa Touch | ThermiVa |
|---|---|---|
| Technology | Fractional CO2 laser | Radiofrequency (RF) energy |
| Session duration | ~5 minutes | ~20-30 minutes |
| Number of sessions | 3 (6 weeks apart) | 3 (1 month apart) |
| Downtime | 48-72 hours (no intercourse) | None |
| Anaesthesia | Topical numbing (optional) | Not required |
| Primary mechanism | Micro-ablation + collagen stimulation | Deep tissue heating + collagen remodelling |
| Best for | Vaginal atrophy, dryness, mild incontinence | Tissue laxity, external tightening, mild incontinence |
| Results duration | 12-18 months | 9-12 months |
| Maintenance | Annual session | Annual session |
Which Symptoms Respond Better to Each Treatment?
MonaLisa Touch is often preferred for:
- Moderate to severe vaginal dryness and atrophy
- Painful intercourse caused by thinning vaginal tissue
- Post-menopausal vaginal changes
- Patients who cannot use hormone therapy
- Lichen sclerosus-related tissue changes
ThermiVa may be a better fit for:
- Vaginal laxity (looseness) after childbirth
- External vulvar tightening and aesthetics
- Mild stress urinary incontinence
- Patients who want zero downtime
- Patients who prefer a non-ablative approach (no micro-injuries to tissue)
Some patients benefit from combining both technologies. For example, MonaLisa Touch to address internal vaginal atrophy and moisture, followed by ThermiVa for external tissue tightening. Dr. Weisberg can advise whether a combined approach makes sense for your specific goals.
What Does the Research Say?
MonaLisa Touch has a larger body of published clinical evidence, with multiple peer-reviewed studies demonstrating significant improvements in vaginal health index scores, dyspareunia (painful intercourse), and patient-reported quality of life. The Journal of Obstetrics and Gynaecology Canada has published research supporting fractional CO2 laser therapy for genitourinary syndrome of menopause.
ThermiVa has a growing evidence base, with studies showing improvements in vaginal tightness, sexual satisfaction, and mild incontinence. However, the research is less extensive compared to CO2 laser therapy, and more large-scale, long-term studies are needed. Both treatments are considered safe with minimal side effects when performed by qualified practitioners.
Cost Comparison in Toronto
Both treatments fall in a similar price range in Toronto. MonaLisa Touch and ThermiVa each typically cost between $800 and $1,500 per session, with package pricing available for the full three-session protocol. The total investment depends on whether you add complementary treatments like the O-Shot to enhance results. FemRenew provides transparent pricing during your consultation.
Making Your Decision: Questions to Bring to Your Consultation
Arriving prepared makes the most of your time with Dr. Weisberg. Consider asking: Which treatment addresses my primary concern most effectively? Am I a candidate for combining both technologies? What maintenance schedule should I plan for? What results have you seen in patients with similar symptoms? Your answers will shape a treatment plan tailored to your anatomy, symptoms, and goals.
Frequently Asked Questions
Is MonaLisa Touch better than ThermiVa?
Neither is universally better — the right choice depends on your symptoms and goals. MonaLisa Touch has stronger clinical evidence for vaginal atrophy and dryness, while ThermiVa excels at tissue tightening with zero downtime. A consultation with a specialist can help determine which is best for you.
Can I do both MonaLisa Touch and ThermiVa?
Yes. Some patients benefit from combining both technologies — using MonaLisa Touch for internal vaginal rejuvenation and ThermiVa for external tightening. Dr. Weisberg can create a combined treatment plan if appropriate.
How long do results from MonaLisa Touch and ThermiVa last?
MonaLisa Touch results typically last 12 to 18 months, while ThermiVa results last 9 to 12 months. Both treatments recommend annual maintenance sessions to sustain benefits.
Is there any downtime with MonaLisa Touch or ThermiVa?
MonaLisa Touch requires 48 to 72 hours of avoiding intercourse and tampon use. ThermiVa has no downtime — you can resume all activities immediately. Neither treatment requires time off work or significant recovery.
Which treatment helps more with incontinence?
Both treatments have shown improvement in mild stress urinary incontinence. MonaLisa Touch strengthens the vaginal wall tissue, while ThermiVa tightens the tissue around the urethra. The best option depends on the underlying cause of your incontinence.
Find the Right Treatment at FemRenew
Choosing between MonaLisa Touch vs ThermiVa is easier when you have expert guidance. Dr. Fay Weisberg will assess your symptoms, discuss your goals, and recommend the treatment — or combination — that offers the best results for your situation. Call FemRenew at (416) 924-4666 or visit our contact page to schedule your consultation at our Toronto clinic.
Medically reviewed by Dr. Fay Weisberg, MD, FRCSC — OB-GYN and Medical Director at FemRenew, Toronto.
