Understanding Intimate Wellness: Votiva and MonaLisa Touch Explained

Intimate wellness is something many women think about but few feel comfortable discussing openly. Changes to vaginal health — whether from childbirth, hormonal shifts, menopause, or simply the passage of time — can affect comfort, confidence, and quality of life in real and significant ways. These changes are normal, but normal does not mean you have to accept discomfort without exploring your options.

At The Modern Woman Med Spa in Santa Rosa, we believe every woman deserves access to private, compassionate care for intimate concerns. Two of the most effective non-surgical treatments currently available are Votiva and MonaLisa Touch. Both address intimate wellness, but they work through different mechanisms and serve slightly different clinical needs.

This guide explains how each treatment works, what conditions they address, what recovery looks like, and how to determine which one — or a combination of both — may be right for you.

Why Intimate Wellness Matters More Than Most Women Realize

Vaginal and vulvar changes happen to nearly every woman at some point in her life. They are a natural part of aging, hormonal transitions, and the physical demands of pregnancy and childbirth. But the fact that they are common does not diminish their impact on your daily life, your relationships, or your sense of self.

Common concerns women bring to our Santa Rosa practice include:

• Vaginal dryness that persists despite over-the-counter lubricants and moisturizers
• Pain, burning, or discomfort during intimacy that was not present before
• A sensation of looseness or reduced internal tone and sensitivity
• Mild to moderate urinary leaking when laughing, coughing, sneezing, or exercising
• Visible changes in the external appearance or texture of the vulvar area
• Decreased confidence or avoidance of intimacy related to these changes
• Recurrent urinary tract infections that may be linked to vaginal tissue thinning

These are not trivial complaints, and they are not “just part of getting older.” They are treatable medical concerns. Having a physician-guided practice that specializes in women’s wellness — and that creates space for these conversations — makes a meaningful difference in outcomes and in how women feel about seeking help.

What Is Votiva?

Votiva is a radiofrequency-based device manufactured by InMode that treats both internal and external intimate concerns. It includes two complementary treatment components that can be used individually or together based on your specific needs.

FormaV (Internal Treatment)

FormaV delivers uniform, controlled RF energy to the internal vaginal canal using a specialized wand applicator. The thermal energy heats the tissue to a therapeutic temperature that stimulates collagen remodeling, increases blood flow, and promotes the restoration of healthy, elastic tissue. This addresses:

• Vaginal laxity — a feeling of internal looseness often caused by childbirth, hormonal changes, or natural aging of the tissue
• Decreased sensation and reduced satisfaction during intimacy
• Mild stress urinary incontinence — the type caused by weakened muscular and connective tissue support around the urethra
• Vaginal dryness related to reduced blood flow and thinning of the mucosal lining

The FormaV procedure takes about 15 to 20 minutes. Most patients describe the sensation as a gentle, comfortable warming feeling — similar to a warm stone massage applied internally. There is no anesthesia required, no preparation, and no recovery downtime.

FractoraV (External Treatment)

FractoraV uses fractional RF energy applied to the external vulvar tissue. Unlike FormaV’s uniform heating, FractoraV creates a pattern of micro-thermal zones that trigger a more intensive collagen remodeling response in the external tissue. It is designed to address:

• Labial laxity, asymmetry, or loss of tone in the external tissue
• Textural changes to the vulvar skin, including roughness or crepiness
• Discoloration or hyperpigmentation of the external area
• Overall external rejuvenation and restoration of a more youthful tissue quality

FractoraV is somewhat more intensive than FormaV. A topical numbing cream is typically applied for comfort before the external treatment. Recovery is minimal — mild swelling and warmth for one to two days is expected, and most women resume all activities within 48 hours.

What Is MonaLisa Touch?

MonaLisa Touch is a fractional CO2 laser treatment designed specifically for vaginal and vulvar tissue regeneration. Developed by DEKA (a medical laser manufacturer based in Italy), it was created with a particular clinical focus on the symptoms of vulvovaginal atrophy — the thinning, drying, and inflammation of the vaginal walls that commonly occurs during and after menopause when estrogen levels decline.

Here is how the treatment works at a tissue level:

• The CO2 laser delivers precise, controlled micro-ablative energy to the vaginal wall tissue through a specialized probe
• This creates thousands of tiny channels in the vaginal mucosa that trigger a strong wound-healing response
• The body responds by generating new collagen fibers, new elastin, and new blood vessels (neovascularization) in the treated tissue
• The result is vaginal tissue that is measurably thicker, more hydrated, more elastic, and better lubricated than before treatment

MonaLisa Touch is particularly effective for women dealing with:

• Vaginal atrophy caused by natural menopause, surgical menopause (hysterectomy with or without oophorectomy), or premature ovarian insufficiency
• Severe, persistent dryness that has not responded to topical estrogen creams or vaginal moisturizers
• Painful intimacy (dyspareunia) specifically related to thinning, fragile vaginal tissue
• Recurrent urinary tract infections linked to changes in vaginal pH and tissue integrity
• Women who cannot use or prefer not to use hormone replacement therapy due to breast cancer history, personal preference, or medical contraindications

A MonaLisa Touch session takes approximately five minutes for the internal treatment. The majority of patients do not require anesthesia — some experience mild pressure, warmth, or a light vibrating sensation. The standard treatment protocol is three sessions spaced six weeks apart, with annual or biannual maintenance sessions recommended for sustained results.

Votiva vs MonaLisa Touch: Understanding the Key Differences

Technology and Mechanism

Votiva uses radiofrequency energy — electromagnetic waves that heat tissue uniformly to stimulate collagen. MonaLisa Touch uses fractional CO2 laser energy — concentrated light that creates micro-ablative channels to trigger a more intensive healing and regenerative response. Both promote collagen production and tissue restoration, but through fundamentally different mechanisms and at different tissue depths.

Primary Clinical Strength

Votiva excels at treating laxity and tone — both internal tightening (FormaV) and external tissue rejuvenation (FractoraV). Its RF energy contracts and remodels collagen for a firmer, more toned result. MonaLisa Touch excels at treating atrophy and dryness — it restores the thickness, moisture production, pH balance, and elasticity of vaginal tissue that has deteriorated due to estrogen loss. If your primary concern is feeling “loose,” Votiva is typically the stronger choice. If your primary concern is dryness, pain with intimacy, or tissue fragility, MonaLisa Touch is typically more appropriate.

External Treatment Capability

Votiva’s FractoraV component is specifically designed for external vulvar tissue treatment — addressing labial tone, texture, and appearance. MonaLisa Touch is primarily an internal vaginal treatment, though external applications exist in some protocols. If external concerns are a significant part of what you want to address, Votiva has a clear advantage in this area.

Best Candidate Profiles

Votiva tends to be the better choice for younger women dealing with post-childbirth laxity, mild incontinence, or reduced sensation. MonaLisa Touch tends to be the stronger option for perimenopausal and postmenopausal women dealing with atrophy, persistent dryness, and painful intimacy caused by tissue thinning.

Many women benefit from using both treatments together. In our Santa Rosa practice, it is not uncommon to combine Votiva for tightening and external rejuvenation alongside MonaLisa Touch for deep tissue restoration. Dr. Shazah Khawaja, Board-Certified OB-GYN, evaluates each patient individually to determine the approach that will produce the best outcome for her specific concerns and stage of life.

What Recovery Looks Like

Both treatments involve minimal recovery, making them practical for women with busy schedules:

• Votiva FormaV: No downtime whatsoever. You can resume all activities, including intimacy, within 24 to 48 hours
• Votiva FractoraV: Mild external swelling and warmth for one to two days. Abstain from intimacy for approximately one week to allow the tissue to heal
• MonaLisa Touch: Abstain from intimacy and avoid inserting anything vaginally for approximately three days. Most women feel completely normal within 24 hours of the treatment and can resume work and regular activities same-day

Safety Considerations and Contraindications

Both Votiva and MonaLisa Touch have strong, well-documented safety profiles when performed by a qualified physician with appropriate training. However, they are not appropriate for every patient. You should not undergo these treatments if you:

• Are currently pregnant or suspect you may be pregnant
• Have an active vaginal infection, urinary tract infection, or sexually transmitted infection
• Have a history of certain gynecological cancers (this requires a detailed discussion with your physician)
• Have an active herpes outbreak in the treatment area
• Have a pacemaker or implanted defibrillator (for Votiva RF specifically)

At The Modern Woman Med Spa, we conduct a thorough medical consultation before recommending any intimate wellness treatment. Your health, safety, and comfort are always the priority — there are no exceptions to this standard.

Why Women in Santa Rosa Trust Our Practice for Intimate Care

Intimate wellness treatments require a level of trust, sensitivity, and medical expertise that goes beyond typical aesthetic procedures. Women choose The Modern Woman Med Spa because:

• Dr. Khawaja is a Board-Certified OB-GYN who understands female pelvic anatomy, reproductive physiology, and the hormonal context of intimate wellness concerns at a specialist level — not a generalist level
• Our office environment is private, warm, and specifically designed to make you feel comfortable discussing topics that you may never have raised with a provider before
• We take time to listen without judgment. No concern is minimized or dismissed as a normal part of aging that you should simply accept
• We offer multiple treatment options and explain the honest benefits, limitations, and tradeoffs of each — giving you the information to make the choice that feels right for your body

Schedule a Confidential Consultation

If you are experiencing changes in your intimate health and want to understand your options, we are here for you. Schedule a confidential consultation at The Modern Woman Med Spa in Santa Rosa. We will talk through your concerns at whatever pace feels comfortable, explain what each treatment can realistically achieve, and create a plan that respects both your body and your goals.

Call us at 707-579-1102 or visit us at 990 Sonoma Ave, Suite 18, Santa Rosa, CA 95404. Everything discussed stays between you and your care team.